目的 探讨应用传统器械经脐行改良单孔腹腔镜阑尾切除术的临床价值。方法 回顾性分析笔者所在医院2010年1月至2012年2月期间行经脐单孔腹腔镜阑尾切除术的52例阑尾炎患者的临床资料，总结手术经验。结果 52例患者均顺利完成手术，平均手术时间为39.2min （18～70min），术后平均住院时间为5d （3～12d）。其中，45例患者成功完成经脐单孔腹腔镜阑尾切除术，2例中转开腹，2例行两孔LA术，3例行三孔LA术。术后2例患者发生切口感染。29例患者获访，随访时间4～18个月，平均12个月，无出血、切口疝、腹腔残余感染、粘连性肠梗阻、阑尾残端瘘等并发症发生。结论 应用传统器械经脐行改良单孔腹腔镜阑尾切除术简单、安全、可行、患者恢复快、并发症少、美容效果较好，但操作难度相对更高。应严格掌握手术适应证，必要时及时增加戳孔或中转开腹。
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.