完全腹膜化腹腔镜腹腔内置片法与经腹腔腹膜前网片法治疗腹股沟疝比较  

Comparison of Laparoscopic Total Peritoneum Intraperitoneal Onlay Mesh and Trans-Abdominal Preperitoneal Laparoscopic Mesh in Inguinal Hernioplasty

作　　者：向国安[1] 陈开运[1] 王汉宁[1] 张刚庆[1] 肖方联[1] 陈规划[2] 

机构地区：[1]广东省第二人民医院普外,微创中心,吴阶平医学基金会-诺道夫微创外科培训中心,广州510317 [2]中山大学附属第三医院肝移植中心,广州510630

出　　处：《中国普外基础与临床杂志》2007年第5期521-523,共3页Chinese Journal of Bases and Clinics In General Surgery

基　　金：吴阶平医学基金资助项目(编号:32027100502)~~

摘　　要：目的探讨完全腹膜化腹腔镜腹腔内置片法(total peritoneum intraperitoneal onlay mesh,TPIPOM)治疗腹股沟疝的有效性及优越性。方法广东省第二人民医院2002年1月至2005年8月期间应用TPIPOM治疗105例腹股沟疝(其中嵌顿疝22例,双侧疝44例,复发疝26例)后的恢复情况及随访结果,并与34例腹腔镜经腹腔腹膜前网片修补术(trans-abdominal preperitoneal laparoscopic mesh repair,TAPP)治疗腹股沟疝的结果相比较。结果平均手术时间〔(30.8±10.3)min vs(68.4±22.4)min〕、平均住院时间〔(3.8±1.3)d vs(4.3±1.5)d〕、平均下床活动时间〔(1.2±0.5)d vs(1.8±0.7)d〕、平均术后疼痛持续时间〔(1.0±0.5)d vs(1.6±0.9)d〕及平均住院费用〔(5000.8±800.5)元vs(8000.5±950.6)元〕TPIPOM组均明显少于TAPP组,差异有统计学意义(P<0.01);两组均无皮下血肿及阴囊水肿发生。两组所有病例均得到随访,平均随访(18.6±8.9)个月,均无复发。结论TPIPOM治疗腹股沟疝是安全、可行的,且创伤小,恢复快,住院时间短,费用少,不易复发,无肠梗阻等并发症,该方法是治疗腹股沟疝的有效方法之一,值得进一步推广。Objective To study the superiority and efficiency of total peritoneum intraperitoneal onlay mesh （TPIPOM） in laparoscopic inguinal hernioplasty. Methods One hundred and five cases of laparoscopic inguinal hernioplasty with TPIPOM and 34 cases of inguinal hernioplasty with trans-abdominal preperitoneal laparoscopic mesh repair （TAPP） were performed from January 2002 to August 2005. Perioperative data and follow-up results were collected and compared in two groups. Results The laparoscopic hernioplasty was successfully performed in all patients. The total operation time, hospital stay, average off-bed time, duration of pain in TPIPOM group were significant shorter than those in TAPP group [（30. 8±10. 3） min vs （68.4±22.4） min, （3.8±1.3） d vs （4.3±1.5） d, （1.2±0.5） d vs （1.8±0.7） d, （1.0±0.5） d vs （1.6±0.9） d, respectively], P〈0.01, the total hospital cost was RMB 5 000.8±800. 5 in TPIPOM group and that was RMB 8 000.5±950.6 in TAPP group （P〈0.01）. No significant scrotal edema was observed postoperatively and no recurrence reported during （18.6 ±8.9） months follow-up in both groups. Conclusion Laparoscopic inguinal hernioplasty with TPIPOM is safe and efficacy with advantages of mini-invasion, simple procedures, shorter operation time, no complications and better recovery.

关 键 词：腹股沟疝 腹腔镜 完全腹膜化腹腔镜腹腔内置片法 

分 类 号：R656.2[医药卫生—外科学]