腹腔镜与开放式完全腹膜外腹股沟疝修补术的临床对比研究  

The comparative clinical study of laparoscopic and open totally extraperitoneal inguinal herniorrhaphy

作　　者：陈士德[1] 李向国[1] 汪晓峰[1] 

机构地区：[1]中国人民解放军海军安庆医院,安徽安庆246003

出　　处：《腹腔镜外科杂志》2016年第7期490-493,共4页Journal of Laparoscopic Surgery

摘　　要：目的：比较腹腔镜与开放完全腹膜外疝修补术（totally extraperitoneal,TEP）治疗成人腹股沟疝的临床效果。方法：回顾分析2010年1月至2014年12月手术治疗并获得随访的221例单侧腹股沟疝患者的临床资料,分为腹腔镜组（n=143）与开放组（n=78）。结果：两组均顺利完成手术,腹腔镜组手术时间平均（75.04±25.49）min,术中出血量平均（12.71±9.24）ml,术后平均住院（4.40±1.43）d,治疗费用平均（8 231±1 838）元,术后24 h疼痛评分平均（1.90±0.87）;开放组手术时间平均（54.94±10.94）min,术中出血量平均（20.43±13.03）ml,术后平均住院（8.14±6.73）d,治疗费用平均（6 592±1 468）元,术后24 h疼痛评分平均（3.12±1.27）。腹腔镜组术后并发症发生率较开放TEP低（P〈0.05）,但开放组手术时间较短,治疗费用较低（P〈0.05）。术后随访6-48个月,两组均无复发病例。结论：腹腔镜与开放TEP各有优缺点,腹腔镜术后患者康复较快,疼痛较轻,切口感染、尿潴留等并发症较少,但其费用偏高。Objective：To compare the effect of laparoscopic and open totally extraperitoneal hemiorrhaphy for adult inguinal hernia. Methods：The clinical data of 221 patients of unilateral inguinal hernia,who underwent operations from Jan. 2010 to Dec. 2014 and were followed up, were retrospectively analyzed. Patients were divided into laparoscopic TEP group （ n = 143 ） and open TEP group （ n = 78）. Results： The surgeries of two groups were successfully completed, the mean operative time of laparoscopic TEP group was （75.04 ± 25.49） min, blood loss was （ 12.71 ± 9.24） ml, hospital stay after surgery was （4.40 ± 1. 43 ） d, treatment costs was （8 231 ± 1 838） yuan, visual analogue score at 24 h after surgery was （1.90 ± 0.87）. The mean operative time of open TEP group was （54.94 ± 10.94） min,blood loss was （20.43 ± 13.03 ） ml, hospital stay after surgery was （8.14 ± 6.73 ） d, treatment costs was （6 592 ± 1 468） yuan, visual analogue score at 24 h after surgery was （3.12 ± 1.27 ）. Compared with open technique ,TEP with laparoscopic technique had less complication rate （P 〈 0.05 ）. However, TEP with open technique had the advantages of shorter operative time and lower cost （ P 〈 0.05 ）. All the patients were followed up, no recurrence happened during a following-up for 6-48 months. Conclusions ：TEP with open and laparoscopic technique both have advantages and disadvantages. TEP with laparoscopic technique has rapider postoperative recovery, less pain, lower infection rate and less urinary retention, so it is worth to be widely used. However, its cost is high. In contrast,TEP with open technique has the advantages of shorter operative time and lower cost, so it is worth to be widely used in primary hospital.

关 键 词：疝 腹股沟 疝修补术 腹腔镜检查 完全腹膜外 对比研究 

分 类 号：R656.21[医药卫生—外科学]