全腹膜外腹腔镜腹股沟疝修补术中单点固定法与免气囊免固定法的对比分析  

Contrastive analysis of single-point-suturing fixation and free airbags free fixation in laparoscopic totally extraperitoneal inguinal hernia repair

作　　者：陆晶晶 吴永丰[1] LU Jingjing;WU Yongfeng(Department of General Surgery,Jiangbei District of Zhongda Hospital affiliated to Southeast University,Nanjing 210000,China)

机构地区：[1]东南大学附属中大医院江北院区普外科(南京市大厂医院),南京210000

出　　处：《临床外科杂志》2018年第11期858-861,共4页Journal of Clinical Surgery

摘　　要：目的分析单点固定和免气囊免固定法全腹膜外腹腔镜腹股沟疝修补术(TEP)的安全性及有效性。方法确诊并行TEP的腹股沟疝病人164例,分为两组,A组68例,免气囊单点固定补片,B组96例,免气囊免固定补片。比较两组手术情况、术后并发症及复发情况。术后3个月采用健康调查简表(SF-36)评价病人的生活质量。结果 A组手术时间为(68. 95±12. 71)分钟,较B组的(83. 04±15. 82)分钟明显缩短(P <0. 05)。A组与B组术中出血量[(8. 96±2. 45)ml和(8. 25±2. 23) ml]、术后肛门排气时间[(15. 68±4. 61)小时和(14. 45±4. 25)小时]、下床活动时间[(21. 12±4. 25)小时和(22. 45±4. 61)小时]、住院时间[(3. 72±1. 13)天和(3. 96±1. 33)天]、术后并发症发生率(11. 76%和21. 88%)比较,差异均无统计学意义(P> 0. 05); A组与B组术后复发率分别为1. 47%和6. 25%,差异无统计学意义(P> 0. 05);两组术后SF-36评分均较术前明显提高(P <0. 05),但组间比较差异无统计学意义(P> 0. 05)。结论 TEP术中补片单点固定安全可行,相比于免固定法可降低手术难度,缩短手术时间。Objective To compare the safety and efficacy of single point suturing fixation and free airbags free fixation in laparoscopic totally extraperitoneal inguinal hernia repair.Methods 82 patients diagnosed with inguinal hernia who underwent TEP were collected.Among them,35 patients underwent singlepointsuturing fixation as group A,47 patients underwent free airbags and free fixation as group B.The operation conditions,postoperative complications and recurrence of the two groups were compared.The quality of life was evaluated by the MOS item short from health survey(SF-36)at 3 months after surgery.Results The operation time of group A was(68.95±12.71)min,which was significantly shorter than(83.04±15.82)min of group B(P<0.05).There were no significant differences of intraoperative blood loss [(8.96±2.45)ml vs(8.25±2.23)ml],postoperative anal ventilatory time[(15.68±4.61)h vs(14.45±4.25)h],ambulation activity time[(21.12±4.25)h vs(22.45±4.61)h],length of stay[(3.72±1.13)d vs(3.96±1.33)d],the incidence of postoperative complications(11.76% vs 21.88%)between group A and B(P>0.05);There was no significant difference of recurrence rate between group A and group B(1.47% vs 6.25%,P>0.05).The SF36 scores at 3 months after surgery were significantly increased than before surgery in the two groups(P<0.05),but there were no significant differences between the two groups(P>0.05).Conclusion The singlepointsuturing fixation in TEP is safe and feasible,which can reduce the difficulty of operation and shorten the operation time when compare4d with free airbags and free fixation.It is worthy of clinical application.

关 键 词：腹股沟疝 全腹膜外修补术 腹腔镜 单点固定 免固定 

分 类 号：R656.21[医药卫生—外科学]