开放完全腹膜外疝修补术治疗老年完全性阴囊疝  

Application experiences of open total extraperitoneal herniorrhaphy for the treatment of completely scrotal hernia in the elderly patients

作　　者：段小鹏[1] 王汉宁[1] 萧金丰[1] 陈开运[1] 向国安[1] Duan Xiaopeng;Wang Hanning;Xiao Jinfeng;Chen Kaiyun;Xiang Guoan(The First Department of General Surgery,Guangdong Second Provincial General Hospital,Guangzhou 510317,China)

机构地区：[1]广东省第二人民医院普外一科,广州510000

出　　处：《中华疝和腹壁外科杂志（电子版）》2020年第2期130-133,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：国家自然科学基金(81641110);广东省自然科学基金(2015A030313725)。

摘　　要：目的探索开放完全腹膜外疝修补术(TEP)治疗老年完全性阴囊疝的临床应用价值。方法回顾性分析2014年7月至2018年6月,广东省第二人民医院收治的106例老年完全性阴囊疝患者资料,分为开放TEP组和腹腔镜经腹腹膜前疝修补术(TAPP)组,观察2组患者手术时间、出血量、血清肿、阴囊积血、尿潴留、术后疼痛、术后谵妄、心肺并发症、术后住院时间、住院费用等情况,评价2组术式的疗效。结果开放TEP组和TAPP组手术时间[(46.5±10.7)min vs(56.7±10.0)min]、住院费用[(8200.5±1599.7)元vs(12031.7±735.6)元]、术后谵妄(0 vs 8.3%)及心肺并发症(0 vs 10.4%)分别比较,开放TEP组显著优于TAPP组,差异有统计学意义(P<0.05)。2组患者在出血量、血清肿、阴囊积血、尿潴留、术后疼痛、术后复发等方面比较,差异均无统计学意义(P>0.05)。结论开放TEP术程时间短、费用较低,安全性可靠,效果肯定,可作为老年完全性阴囊疝的一种合理术式。Objective To investigate clinical effect of open total extraperitoneal herniorrhaphy(TEP)for the treatment of completely scrotal hernia in the elderly patients.Methods Made a retrospective study of 106 completely scrotal hernia in the elderly patients in Guangdong second provincial general hospital from July 2014 to June 2018 and divided them into observation group and control group.The observation group used open total extraperitoneal herniorrhaphy(open TEP)for treatment,while control group used laparoscopic trans-abdominal preperitoneal hernia repair(TAPP).The index including operation time,total cost,incidence of postoperative complications of cardiorespiratory and deliration,intraoperative blood loss,postoperative seroma,acute urinary retention,hospital stay and recurrence rat were observed to evaluate the curative effect of open total extraperitoneal herniorrhaphy.Results The operation time,total cost,incidence of postoperative complications of cardiorespiratory and deliration in open TEP group and TAPP group was(46.5±10.7)minutes vs(56.7±10.0)minutes,(8200.5±1599.7)yuan vs(12031.7±735.6)yuan,0 vs 8.3%,0 vs 10.4%,respectively.There was statistical difference between the two groups.But there was no statistical difference in between the two groups in terms of intraoperative blood loss,postoperative seroma,acute urinary retention,hospital stay,recurrence rate.Conclusion The open total extraperitoneal herniorrhaphy is shorter in operation time,lower in total cost and reliable in safety.It is a rational operation for completely scrotal hernia in the elderly patients.

关 键 词：疝 阴囊 老年人 疝修补术 

分 类 号：R656.2[医药卫生—外科学]