正中切口腹股沟疝腹膜外修补

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1、手机号：18930819151　　　Ｅ-ｍａｉｌ：srongxun@hotmail.com正中切口行腹股沟疝腹膜外修补术建议改为：开放完全腹膜外疝修补术102例，其他内容相应修改102例孙荣勋陈江张大伟李小燕*姚君良（复旦大学附属金山医院普外科，上海201508）[摘要]目的　总结腹股沟疝行正中切口腹膜外修补术的解剖要点和初步操作体会。方法2011年2月～2015年8月102例腹股沟疝经正中切口行完全腹膜外修补，手术步骤依次为分开腹直肌，分离腹膜外筋膜和腹横筋膜间粘连，建立腹膜外间隙，剥离疝囊，以疝环为中心将补片完全覆盖肌耻骨孔，补片与腹直

2、肌缝合固定。结果手术时间28~55min，平均37min。术后住院时间1~4d，平均1.5d。术后尿储留3例（2.9%），皮下、阴囊血清肿和血肿3例(2.9%)，无慢性疼痛。95例随访6个月~5年，平均3年，无慢性疼痛，术后复发2例（1.9%），均发生在术后6个月，采用网塞法行再次修补，其余患者无异常。结论经正中切口的腹膜外修补具有操作便捷、术后腹股沟区无不适感等优势，且可作为腔镜手术的垫脚石。[关键词]腹膜外修补；腹股沟疝；正中切口OperativeTechniquesExperience102CasesofInguinalHerniaE

3、xtraperitonealRepairthroughMidlineIncisionSUNRongxun，CHENJiang，ZHANGDawei，etal.DepartmentofGeneralSurgery,JinshanHospitalAffiliatedtoFudanUniversity,Shanghai201508,China[Abstract]Objective:Tosummarizetheexperienceoftheanatomiclandmarksandoperativetechniquesintheextraperito

4、nealrepairthroughmidlineincisionforinguinalhernia.Methods：FromFeb2011toAug2015,102patientswithinguinalherniareceivedextraperitonealherniorrhaphythroughmidlineincision.Theoperativeprocedurewasasfollows.Afterseparatingtherectusabdominismuscleswereseparated,theadhesionbetween

5、theextroperitonealfasciaandthetransvasalisfasciawasdissected,andthepreperitonealspacewasestablished,thentheherniasacwasisolated.Theprosthesispatchwasplacedonthemyopectinealorifice,theherniaringlocatedlocatingatthecenterofthepatch.Finally,thepatchrimwasfixedtotherectus.Resu

6、lts:Theoperativetimewas28~55min,andthemeantimewas37.2min.Thepostoperativehospitalstaywas1~4d,andthemeanstaywas1.5d.Urinaryretentionoccurredin3cases(2.9%).Seromaoccurredin3cases(2.9%).95caseswerefollowedupfor6months~5years,withanaverageof3years.Therewasnopatientwithchronicp

7、ain,but2casesofpostoperativerecurrence(1.9%).Bothrecurrencesoccurredin6monthsaftertheoperation,andreceivedreoperationswithplugmethod.Theotherpatientswerenotabnormal.Conclusion:Theextraperitonealrepairthroughmidlineincisionhasadvantageofmoreconvenientprocedure,lesspostopera

8、tivegroindiscomfort.Itcouldalsobeusedasasteppingstonetothelaparoscopicoperation.[Keywords