目的 探討應用傳統器械經臍行改良單孔腹腔鏡闌尾切除術的臨床價值。方法 回顧性分析筆者所在醫院2010年1月至2012年2月期間行經臍單孔腹腔鏡闌尾切除術的52例闌尾炎患者的臨床資料，總結手術經驗。結果 52例患者均順利完成手術，平均手術時間為39.2min （18～70min），術后平均住院時間為5d （3～12d）。其中，45例患者成功完成經臍單孔腹腔鏡闌尾切除術，2例中轉開腹，2例行兩孔LA術，3例行三孔LA術。術后2例患者發生切口感染。29例患者獲訪，隨訪時間4～18個月，平均12個月，無出血、切口疝、腹腔殘余感染、粘連性腸梗阻、闌尾殘端瘺等并發癥發生。結論 應用傳統器械經臍行改良單孔腹腔鏡闌尾切除術簡單、安全、可行、患者恢復快、并發癥少、美容效果較好，但操作難度相對更高。應嚴格掌握手術適應證，必要時及時增加戳孔或中轉開腹。
Objective To study anatomy of mortis corona vascular and analyze its characteristics and clinical significances in laparoscopic total extraperitoneal hernia repair (TEP). Method The clinical data of 45 patients with inguinal hernia underwent laparoscopic TEP from July 2013 to October 2015 in the Fourth People’s Hospital of Zigong City were collected. Results ① There were 45 patients with inguinal hernia a total of 52 bilateral inguinal hernias (15 direct hernias, 37 oblique hernias). The total appear rate of corona mortis vascular was 61.5% (32/52). The appear rate of corona mortis artery was significantly higher than that of the corona mortis vein〔46.2% (24/52)versus 34.6% (18/52),P<0.05〕, the diameter of the corona mortis artery was significantly smaller than that of the corona mortis vein〔(3.2±0.3) mmversus (3.4±0.4) mm,t=2.231,P<0.05〕. ② The appear rates of corona mortis artery and vein in the male patients were significantly higher than those of the female patients (P<0.05). Compared with the female patients, the age of onset was older (P<0.05), thickness of abdominal wall was thinner (P<0.05), diameter of corona mortis vascular was bigger (P<0.05) in the male patients. ③ The total appear rate of corona mortis vascular in the patients with direct hernia was significantly lower than that of the patients with oblique hernia (P<0.05). The age of onset of the patients with direct hernia was significantly older than that of the patients with oblique hernia (P<0.05). Conclusions There is a higher appear rate of corona mortis vascular in patients with oblique hernia, which in male patients is higher as compared with female patients. Age of onset of male patient with inguinal hernia is older than that of female patient with inguinal hernia. It suggests that appear of corona mortis vascular might be associated with degeneration of abdominal wall. It has a certain role for localization and avoidance of corona mortis vascular in TEP.