两种保留子宫圆韧带法在腹腔镜经腹腹膜前腹股沟疝修补术中的临床疗效

翁晓奇　　姜宇朋　　张伟波

[关键词] 女性;腹股沟疝;子宫圆韧带;腹腔镜疝修补术

[中图分类号] R61          [文献标识码] A          [文章编号] 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

腹股沟疝是普外科的一种常见疾病，国外数据显示，女性腹股沟疝约占全部腹股沟疝的6%[1]，男女性腹股沟疝发病率比例为10～15∶1[2-3]，女性腹股沟疝发病率远低于男性。由于女性腹股沟管内有子宫圆韧带通过，且子宫圆韧带与腹膜粘连致密，所以既往行腹腔镜下腹股沟疝修补术时，多选择离断子宮圆韧带。如何在完成腹腔镜下腹股沟疝修补的同时保留子宫圆韧带，是目前亟待解决的问题。回顾性分析近年我院收治的行腹腔镜手术治疗的32例女性腹股沟疝患者的临床资料，32例患者分别采用了Keyhole法及T-Dissection法保留子宫圆韧带[4-5]，现报道如下。