腹腔镜与开放腹股沟疝修补术术后并发症的临床研究  

Clinical studies of postoperative complications between open and laparoscopic inguinal hernia herniorrhaphy

作　　者：郭海洋[1] 沈海玉[2] 姜永胜[2] 孙少川[2] 郑春宁[2] 

机构地区：[1]潍坊医学院,山东潍坊261000 [2]山东大学附属济南市中心医院

出　　处：《腹腔镜外科杂志》2014年第5期376-378,共3页Journal of Laparoscopic Surgery

摘　　要：目的:对比分析腹腔镜与开放腹股沟疝无张力修补术术后并发症发生率,总结术后并发症的发生原因与处理措施。方法:回顾分析2011年9月至2012年9月为491例腹股沟疝患者行疝修补术的临床资料,将患者分为开放组与腹腔镜全腹膜外(total extraperitoneal,TEP)修补术组(TEP组),分别统计术后并发症情况。结果:开放组术后11例发生并发症,发生率5.58%,其中手术操作区及阴囊浆液肿3例、尿潴留3例、切口感染2例、腹股沟区异物感3例;腹腔镜组术后发生4例并发症,发生率1.36%,其中手术操作区及阴囊浆液肿2例、尿潴留1例、腹股沟区异物感1例,两组总并发症发生率差异有统计学意义(P<0.05)。结论:腹腔镜无张力疝修补术术后并发症发生率更低,是安全、有效的疝修补术式。但腹腔镜手术因需CO2气腹,并存在一定的学习曲线,因此需根据患者自身情况、疝的类型等慎重选择手术方式。Objective ：To compare and analyze the postoperative complication incidence of open tension-free repair in the treat- ment of inguinal hernia with laparoscopic operation, and summarize the causes and treatment methods of postoperative complications. Methods：The clinical data of 491 patients with inguinal hernia who underwent open or laparoscopic herniorrhaphy during Sep. 2011 and Sep. 2012 were analyzed retrospectively. The postoperative complications were respectively calculated by statistical software SPSS 17.0 to analyze whether the incidence of complications was different. Resnits：There were 11 cases of postoperative complication in open group, the incidence was 5.58%, which included 3 cases of seroma at the operative area and scrotum, 3 cases of postoperative urinary retention,2 cases of incision infection,3 cases of foreign body sensation in the groin area;there were 4 cases of laparoscopic postopera- tive complications, the rate was 1.36%, including 2 cases of seroma at operating area and scrotum, 1 case of postoperative urinary reten- tion, 1 case of foreign body sensation in the groin area. The difference of overall complication rate between the two groups was statistical- ly significant （ P 〈 0.05 ）. Conclusions ： Laparoscopic tension-free herniorrhaphy is a safe and effective method with a lower incidence of postoperative complications. Because of CO2 pneumopefitoneum and learning curve ,the choice of operative method should be considerate according to the patients＇ conditions and type of hernia.

关 键 词：疝 腹股沟 疝修补术 腹腔镜检查 手术后并发症 

分 类 号：R656.21[医药卫生—外科学]