全腹膜外与经腹膜腹腔镜腹股沟疝修补术治疗网塞型补片修补术后复发性腹股沟疝的体会  

Experience of total extraperitoneal and transabdominal preperitoneal herniorrhaphy in the treatment of postoperative recurrent inguinal hernia after plug perfix mesh repair

作　　者：孟飞龙[1] 英明[1] 张春宇[1] 黄鹤[1] 姜磊[1] 

机构地区：[1]黑龙江哈尔滨市第二医院普外科,150056

出　　处：《中国实用医药》2017年第20期36-38,共3页China Practical Medicine

摘　　要：目的对比分析全腹膜外(TEP)与经腹膜腹腔镜(TAPP)腹股沟疝修补术治疗网塞型补片(plug perfix mesh)修补术后复发性腹股沟疝的临床效果。方法 64例plug perfix mesh修补术后复发性腹股沟疝并行腹腔镜疝修补术患者,患者首次手术均为plug perfix mesh修补术,根据二次手术方式分为TAPP组(39例)和TEP组(25例)。TAPP组患者给予TAPP手术方式,TEP组患者给予TEP手术方式。比较两组临床效果。结果两组手术时间比较,差异无统计学意义(P>0.05);TAPP组术中出血量显著少于TEP组,术后住院时间长于TEP组(P<0.05)。TEP组术后3 d疼痛发生率为0,术后3 d血肿发生率为4.00%,术后1 d尿潴留发生率为16.00%,分别与TAPP组的2.56%、5.13%、15.38%比较,差异无统计学意义(P>0.05)。结论腹腔镜疝修补在plug perfix mesh修补术后复发性腹股沟疝中具有较高的可行度,可以有效的减少副损伤等并发症的发生;TEP应用技术与TAPP技术相比并不存在明显困难,但在破损腹膜修补以及腔镜操作中却提出了更高的要求。Objective To compare and analyze the clinical effect of total extraperitoneal （TEP） and transabdominal preperitoneal herniorrl^aphy （TAPP） in the treatment of postoperative recurrent inguinal hernia after plug perfix mesh repair. Methods A total of 64 plug perfix mesh repair postoperative recurrent inguinal hernia patients with laparoscopic hernia repair all received plug perfix mesh repair first, and they were divided by secondary operation methods into TAPP group （39 cases） and TEP group （25 cases）. TAPP group was treated with TAPP operation, and TEP group was treated with TEP operation. Clinical effect was compared in two groups. Results Both groups had no statistically significant difference in operation time （P〉0.05）. TAPP group had significantly less intraoperative bleeding volume than TEP group and longer postoperative hospital stay time than TEP group （P〈0.05）. TEP group had no statistically significant difference in incidence of pain and hematoma in postoperative 3 d as 0 and 4.00%, and incidence of urinary retention in postoperative 1 d as 16.00%, comparing with 2.56%, 5.13% and 15.38% in TAPP group （P〉0.05）. Conclusion Laparoscopic hernia repair has high feasibility for recurrent inguinal hernia after plug perfix mesh repair, and it can effectively reduce the complications of secondary injury; TAPP technology has no obvious difficulties comparing with TEP technology, but it puts forward higher requirements in the damage peritoneal repair and endoscopic operation.

关 键 词：腹股沟疝修补术 全腹膜外 经腹膜腹腔镜 网塞型补片修补术 

分 类 号：R656.21[医药卫生—外科学]