单点固定与不固定补片的完全腹膜外腹腔镜腹股沟疝修补术疗效比较  

Laparoscopic totally extraperitoneal inguinal hernia repair by using one-point-suturing fixed soft mesh

作　　者：王大川[1] 鲍峰[1] 刘文[1] 于颖娟[1] 钟春林[1] WANG Da-chuan;BAO Feng;LIU Wen;YU Ying-juan;ZHONG Chun-lin(Department of General Surgery,Mianyang Central Hospital（Mianyang 621000,China)

机构地区：[1]绵阳市中心医院普外科,四川绵阳621000

出　　处：《中国现代普通外科进展》2018年第4期271-275,共5页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:比较单点固定与不固定软质补片的完全腹膜外腹腔镜腹股沟疝修补术(TEP)治疗腹股沟疝的临床疗效。方法:回顾性分析2013年1月—2015年3月在绵阳市中心医院普外科确诊并行TEP手术的90例单侧腹股沟疝患者,均采用软质补片,其中55例行免气囊、免固定的TEP(免固定组),35例行免气囊、单点固定法TEP(单点固定组),比较两组术后使用镇痛药物比率、胃肠功能恢复时间、术后卧床时间、住院时间、术后并发症发生率等。结果:与免固定组相比,单点固定组手术时间较短,卧床时间较少、术后排气时间、进食时间较早,差异均有统计学意义(P<0.05);术中出血量、术后镇痛药应用比率、住院时间、术后血清肿发生率差异均无统计学意义(P>0.05)。两组术后均无复发。结论:与免固定TEP相比,单点固定软质补片的TEP治疗腹股沟疝可以显著缩短手术时间,降低手术难度,患者术后恢复较快。Objective： To investigate the feasibility and applicability of laparoscopic totally extraperitoneal（TEP） inguinal hernia repair by using one-point-suturing fixed soft mesh. Methods： 90 male patients were retrospectively analyzed from Jan. 2013 to Mar. 2015, all of them were diagnosed with unilateral inguinal hernia and treated with TEP surgery. Among them, there were 55 patients with free of air bag and free of fixed TEP（free fixed group） and 35 patients with free of air bag and fixed by one-point-suturing TEP（one-point-suturing fixed group）, all of patients were used by soft mesh. They were analyzed about their differences of postoperative pain, gastrointestinal function recovery time, the postoperative feeding time, the bedside movement time, the hospitalization time,and the incidence of postoperative complications. Results： Compared with the free fixed group, the operation time of the one-point-suturing fixed group was significantly shorter, the bedside movement time earlier, gastrointestinal function recovery time earlier,the postoperative feeding time earlier（P 0.05）, but the difference were not statistically significant in intraoperative blood loss, the postoperative pain, the hospitalization time, the incidence of postoperative seroma（P 0.05）, and there were no recurrence in both groups. Conclusion： Compared with the free fixed TEP, the one-point-suturing fixed TEP has significantly shorter operation time, reduce the operation difficulty,and make the postoperative recovery faster, so it is safe, feasible and appropriate to application.

关 键 词：疝 腹股沟 全腹膜外 疝修补术 腹腔镜检查 单点固定 

分 类 号：R256.45[医药卫生—中医内科学]