Phẫu thuật nội soi tapp điều trị thoát vị bẹn

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Tác giả: Minh Thảo Nguyễn, Thanh Xuân Nguyễn, Anh Vũ Phạm, Đình Khôi Trương

Ngôn ngữ: Vie

Ký hiệu phân loại: 617 Miscellaneous branches of medicine Surgery

Thông tin xuất bản: Tạp chí Y học lâm sàng, 2021

Mô tả vật lý: 84-89

Bộ sưu tập: Metadata

ID: 393790

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Thoát vị bẹn là một bệnh lý ngoại khoa thường gặp và có nhiều tác giả đưa ra nhiều kỹ thuật mổ khác nhau. Phẫu thuật xuyên phúc mạc tiếp cận khoang trước phúc mạc (TAPP) với nhiều ưu điểm như tiếp cận phẫu trường nội soi rộng rãi, các mốc giải phẫu rõ ràng, có thể quan sát, đánh giá và xử trí tạng thoát vị khá dễ dàng, có thể phát hiện thoát vị bẹn đối diện và xử trí những bệnh lý kèm theo trong ổ phúc mạc. Nghiên cứu mô tả có theo dõi 125 bệnh nhân được chẩn đoán thoát vị bẹn tại Bệnh viện Trung Ương Huế và Bệnh viện trường Đại học Y - Dược Huế từ tháng 6/2016 đến tháng 3/2019. Tuổi trung bình 56,25 ± 19,06. Nam chiếm 97,6%. Thoát vị bẹn có triệu chứng 76,8%, có biến chứng 23,2%. Thoát vị bẹn 1 bên 92%, 2 bên 8%. Thoát vị bẹn ẩn đối bên phát hiện trong mổ 2,4%. TAPP 1 bên 92,8%, TAPP 2 bên 7,2%, TAPP kèm phẫu thuật khác 2,4%. Thời gian mổ trung bình 1 bên là 48,62 ± 13,05 phút, 2 bên là 66,11 ± 12,19 phút. Không có tai biến trong mổ. VAS sau mổ 24 giờ: 3,53 ± 0,56. Tụ dịch vùng bẹn sau mổ 11,2%. Thời gian nằm viện sau mổ 4,41 ± 1,25 ngày. Phẫu thuật TAPP là một phẫu thuật an toàn, có thể thực hiện được. Phẫu thuật TAPP có thể phát hiện và xử trí những tổn thương trong ổ phúc mạc cũng như các bệnh lý đi kèm., Tóm tắt tiếng anh, Inguinal hernia is one of the commonest surgical diseases and there are many different techniques applied. The laparoscopic trans - abdominal pre - peritoneal (TAPP) repair allows a better view of the inguinal anatomy, evaluation of opposite side and resolve combined peritoneal diseases as well. A prospective study was carried in 125 cases with inguinal hernia that have been treated by laparoscopic trans - abdominal pre-peritoneal (TAPP) repair.The mean age was 56.25 ± 19.06 years old. 96.7% were male. 76,8% of hernia were symptomatic, and 23.3% were complicated. 92% of hernia were unilateral, 8% were bilateral, 2.4% were occult. 92.8% would perfom an unilateral TAPP repair, 7.2% bilateral TAPP repair, 2.4% simultaneous TAPP and cholecystectomy. The mean operative time was 48.62 ± 13.05 minutes for unilateral TAPP, 66.11 ± 12.19 minutes for bilateral TAPP. The mean VAS 24h post - op was 3.53 ± 0.56. Regarding postoperative complications, inguinal seroma was detected in 11,2% of cases. The mean postoperative hospital stay was 4.41 ± 1.25 days.TAPP is a safe and feasible procedure, allows evaluation of opposite side and resolve combined peritoneal diseases.

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