腹膜的窗帘化在腹腔镜经腹腹膜前疝修补术中的应用

目的探讨腹膜的窗帘化在腹腔镜经腹腹膜前疝修补术（TAPP）中的临床意义。 方法选择2016年1月至2019年12月安徽省合肥市第二人民医院普外科行TAPP手术的60例腹股沟疝患者，其中双侧疝患者15例，共75侧疝。采用随机数字表法分为2组，对照组37侧，未行腹膜窗帘化；试验组38侧，行腹膜窗帘化。 结果60例患者均行标准TAPP手术。全组患者手术时间70（50～120）min、术中出血量2（1～3）ml、术后住院时间5（2～7）d、无术中并发症。所有患者术后疼痛视觉模拟评分<3分。本组患者均完成1个月至2年随访，无复发、感染的病例，随访期内发生并发症6侧（8%），均为术后血清肿的发生。 结论腹膜的窗帘化在TAPP中可明显易于补片展平及腹膜的关闭缝合，减少腹膜的破损，减少术后并发症的发生及腹股沟疝的复发,具有十分重要的临床意义。

Clinical significance of peritoneal drapes in laparoscopic transabdominal preperitoneal hernia repair

ObjectiveTo investigate the clinical significance of peritoneal drapes in transabdominal laparoscopic inguinal hernia repair. MethodsA total of sixty patients with inguinal hernia performed TAPP in the department of general surgery of Hefei second people's hospital between January 2016 and December 2019 were enrolled into the study, including 15 patients with bilateral hernia, with a total of 75 hernias. The patients was divided into two groups according to random number table, including 31 patients (37 sides) in control group with no draping peritoneal and 29 patients (38 sides) in experiment group with draping peritoneal. ResultsIn the whole group, the operative time was 70 (50 to 120) minutes, intraoperative blood loss was 2 (1 to 3) ml, postoperative hospital stay was 5 (2 to 7) days, and there were no intraoperative complications. Postoperative visual analogue scores of all patients were less than 3 points. All the patients in this group were followed up for 1 month to 2 years without recurrence or infection. During the follow-up period, complications occurred on 6 sides (8%), all of which were postoperative seroma. ConclusionThe draping of peritoneum is of great clinical significance in the transabdominal laparoscopic inguinal hernia repair, which can easily smooth the mesh and close the peritoneum, reduce the damage of peritoneum, reduce the occurrence of postoperative complications and the recurrence of inguinal hernia.