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目的探讨在开放腹股沟疝修补手术中游离精索新术式的可行性。方法 2009年12月至2011年5月,南方医科大学附属南海医院普外三科在择期78例(双侧疝19例)Lichtenstein疝修补术中采用新术式游离精索(游离精索的解剖平面在提睾肌筋膜浅层与腹横筋膜之间),观察有无出血和神经损伤,记录所需时间,随访术后并发症。结果 78例手术中修补斜疝82侧,直疝17侧;游离精索的时间为4～11min,平均6.9min;无一例发生1mL以上的出血;游离过程中损伤髂腹股沟神经1例;术后切口脂肪液化3例,术后耻骨上区疼痛1例,随访3个月以上无慢性疼痛病例。结论在开放腹股沟疝修补术中,采用新术式游离精索的方法简单可行。

Technique for mobilizing spermatic cord in open hernioplasty: a report of 78 patients

Objective To explore the security and feasibility of a new technique for mobilization of spermatic cord in hernioplasty for adult male. Methods Between December 2009 and May 2011, a new method for mobilizing spermatic cord was used in elective Lichtenstein tension-free hernioplasty for 78 patients(19 patients with bilateral hernias)in the Department Ⅲ of General Surgery, Affiliated Nanhai Hospital of Southern Medical University. Blood loss, nerve injury and the time consuming for mobilizing spermatic cord were recorded. All the patients were followed up 3 months for post-operative complications. Results Eighty-two cases of indirect hernia and 17 cases of direct hernia were repaired successfully in 78 patients. Spermatic mobilization was completed in 4-11 min with an average duration of 6.9 min. None of the patients had hemorrhage of more than 1 mL. One case of ilioinguinal nerve injury was suffered during the procedure. Three cases presented with postoperative fat liquefaction of the wound. Postoperative suprapubic region pain occurred in 1 case. No chronic pain was observed in the following 3 months. Conclusion The new technique for spermatic cord mobilization in hernioplasty is simple and feasible, which deserved promotion in hernioplasty.