兩種保留子宮圓韌帶法在腹腔鏡經腹腹膜前腹股溝疝修補術中的臨床療效

翁曉奇　　姜宇朋　　張偉波

[關鍵詞] 女性;腹股溝疝;子宮圓韌帶;腹腔鏡疝修補術

[中圖分類號] R61? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1673-9701（2021）19-0026-04

Clinical effects of two methods of preserving uterine round ligaments in laparoscopic transabdominal preperitoneal inguinal herniorrhaphy

WENG Xiaoqi? ?JIANG Yupeng? ?ZHANG Weibo

Department of Gastrointestinal Surgery，the First People′s Hospital of Tongxiang City in Zhejiang Province，Tongxiang 314500，China

[Abstract] Objective To investigate the clinical effects of two methods of preserving uterine round ligaments in laparoscopic transabdominal preperitoneal （TAPP） inguinal herniorrhaphy. Methods Retrospective analysis was performed on the clinical data of 32 women who underwent laparoscopic TAPP inguinal herniorrhaphy and retained uterine round ligaments in our hospital from July 2013 to September 2019. The uterine round ligaments were preserved in 14 patients in the control group by Keyhole method and in 18 patients in the observation group by T-Dissection method. The operative time，postoperative hospital stay，postoperative infection，postoperative seroma，postoperative urinary retention and postoperative recurrence of the two groups were compared and analyzed. Results All the 32 patients successfully completed laparoscopic TAPP inguinal herniorrhaphy. There were no statistically significant difference of average operative time and the average postoperative hospital stay between the observation group and the control group（P>0.05）. There was 1 case of seroma in the postoperative observation group，and the difference of seroma rate between the two groups was not statistically significant （P>0.05）. There were no complications such as postoperative infection，postoperative urinary retention and postoperative recurrence between the two groups. Conclusion During laparoscopic TAPP inguinal herniorrhaphy，both methods preserve the function of uterine round ligaments and are safe and effective. However，T-Dissection method preserves the integrity of the patch and avoids the uncertainty during the incision and suture of surgeons，making it more worthy of clinical promotion.

[Key words] Female; Inguinal hernia; Uterine round ligaments; Laparoscopic inguinal herniorrhaphy

腹股溝疝是普外科的一種常見疾病，國外數據顯示，女性腹股溝疝約占全部腹股溝疝的6%[1]，男女性腹股溝疝發病率比例為10～15∶1[2-3]，女性腹股溝疝發病率遠低于男性。由于女性腹股溝管內有子宮圓韌帶通過，且子宮圓韌帶與腹膜粘連致密，所以既往行腹腔鏡下腹股溝疝修補術時，多選擇離斷子宮圓韌帶。如何在完成腹腔鏡下腹股溝疝修補的同時保留子宮圓韌帶，是目前亟待解決的問題?；仡櫺苑治鼋晡以菏罩蔚男懈骨荤R手術治療的32例女性腹股溝疝患者的臨床資料，32例患者分別采用了Keyhole法及T-Dissection法保留子宮圓韌帶[4-5]，現報道如下。