腹腔镜与开放式无张力修补术治疗复发性腹股沟疝对比研究  

Comparison of laparoscopic vs open mesh techniques for recurrent inguinal hernias

作　　者：张辉[1] 李健文[1] 郑民华[1] 李华青[1] 解轶生[1] 王磊[1] 王明亮[1] 陆爱国[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院普外科上海市微创外科临床医学中心,上海200025

出　　处：《中国实用外科杂志》2008年第5期373-375,377,共4页Chinese Journal of Practical Surgery

摘　　要：目的评价腹腔镜技术治疗复发性腹股沟疝的安全性和有效性，讨论术式选择。方法回顾性分析2003年1月至2006年12月上海交通大学医学院附属瑞金医院收治的58例（63例次）复发性腹股沟疝的临床资料。其中腹腔镜腹股沟疝修补术（LIHR）27例（30例次），开放式无张力修补术（OMR）31例（33例次）。术后病人均得到随访，随访时间12—36个月（中位时间18个月）。结果两组在手术时间差异（P=0．072）、术后住院天数差异（P=0.076）、术后第2天疼痛分数（VAS）差异（P=0．084）、2周内恢复非限制性活动例数差异（P=1．000）均无统计学意义；LIHR组的住院费用高于OMR组，差异有统计学意义（P=0．000）；两组在随访期内均无复发，总并发症发生率分别为6．7％（2／30）和9．1％（3／33），差异无统计学意义（P=1．000）。结论LIHR在治疗复发性腹股沟疝时与OMR同样安全有效，术式选择取决于前次手术的类型和外科医师的临床经验。Objective To evaluate the clinical safety and efficiency of laparoscopic inguinal hernia repair （LIHR） for recurrent hernia, and to discuss the selection of procedures. Methods From Jan, 2003 to Dec, 2006 in Ruijing Hospital, Shanghai Jiaotong University School of Medicine, a non-randomized control study was carried out on 58 patients with 63 recurrent inguinal hernias,including 30 LIHR for 27 patients and 33 open mesh repair （OMR） for 31 patients. All patients were followed up for 12 -36 months with a median of 18 months, Results There was no significant difference between LIHR and OMR when considering operating time （ P = 0. 072 ）, postoperative hospital stay （ P = 0. 076 ）, visual analogue pain scores （ P = 0. 084 ） and time to return to usual activity （ P = 1.000）. The cost in hospital of LIHR was significantly higher than OMR （ P = 0.000 ）, There was no recurrence in either group and the total incidence rates of postoperative complications were 6, 7% （2/30） and 9. 1% （3/33） respectively in the two groups （ P = 1,000）. Conclusion LIHR and OMR are both safe and effective techniques for recurrent inguinal hernia, The choice of method should be based on previous repair type and surgeon＇ s experience,

关 键 词：腹腔镜 腹股沟疝 无张力疝修补术 

分 类 号：R6[医药卫生—外科学]