Kugel手术与腹腔镜完全腹膜外疝修补术的比较研究  

Comparative study of Kugel repair and laparoscopic total extraperitoneal herniorrhaphy in treatment of inguinal hernia

作　　者：刘书强[1] 赵象文[1] 梁志宏[1] 华伟[1] 韩月锋[1] 江雪峰[1] 

机构地区：[1]南方医科大学附属小榄医院普外科,广东省中山528415

出　　处：《中华疝和腹壁外科杂志（电子版）》2015年第2期38-40,共3页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的比较Kugel疝修补术与腹腔镜完全腹膜外疝修补术(TEP)治疗腹股沟疝的临床效果。方法回顾性分析2009年8月至2013年7月,南方医科大学附属小榄医院收治的385例腹股沟疝患者的临床资料,根据腹膜外疝修补术方式分为Kugel组(163例)与TEP组(222例)。比较二组患者手术时间、住院时间、恢复正常活动时间、住院费用、术后腹股沟区疼痛情况、术后并发症等。结果二组患者手术时间、住院时间、切口感染、疝复发率比较,差异无统计学意义(t=0.018、5.563、χ2=0.647、0.048,P=0.057、0.206、0.421、0.826);术后腹股沟区疼痛发生率、恢复正常活动时间、血清肿发生率,TEP组明显少于Kugel组(χ2=5.958、t=24.545、χ2=4.438,P=0.015、0.000、0.035);住院费用Kugel组低于TEP组(t=8.072,P=0.000)。结论 TEP与Kugel 2种术式治疗腹股沟疝均可取得良好疗效,TEP具有术后疼痛轻、恢复快等优点,但住院费用较高,临床医师需根据患者的经济水平、意愿以及术者水平等综合选择最佳的手术方式。Objective To compare the clinical efficiency between open total extraperitoneal herniorrhaphy （Kugel） and laparoscopic total extraperitoneal herniorrhaphy （TEP） in treatment of inguinal hernia. Methods From August 2009 to July 2013, 385 patients in Xiaolan Hospital of Southern Medical University who underwent preperitoneal hemiorrhaphy for inguinal hernia were retrospectively analyzed. The patients were divided into two groups according the procedure performed： Kugel group （n = 163 ） and TEP group （n = 222 ）. The operation time, hospital stay, time to normal activities, cost of hospitalization, postoperative inguinal pain and postoperative complications were compared between the two groups. Results All patients were followed-up for 6 to 12 months after operation. No significant differences were founded between the two groups in the operation time, hospital stay, wound infection and recurrence rate （t = 0. 018, 5. 563, χ2 = 0. 647, 0. 048, P = 0. 057, 0. 206, 0. 421, 0. 826）. However, postoperative inguinal pain, the time to resume normal activities and incidence of seroma in TEP group were significantly less than those in the Kugel group, and the differences between the two groups were significant （χ2 = 5. 958, t = 24. 545, χ2 = 4. 438, P=0. 015, 0. 000, 0. 035）. But in terms of cost of hospitalization, Kugel group was less than TEP group （t = 8. 072, P = 0.000 ）. Conclusion Both TEP and Kugel are effective in the treatment of inguinal hernia. TEP group has the advantages of less postoperative pain and faster recovery, but high cost of hospitalization. The surgeon should choose the optimum treatment on the basis of economic level and intention of patients, as well as experience of surgeon.

关 键 词：疝 腹股沟 疝修补术 腹腔镜 

分 类 号：R656.2[医药卫生—外科学]