腹腔镜下完全腹膜外补片植入术和腹腔镜经腹腹膜前疝修补术对男性腹股沟疝患者精索血管及睾丸功能的影响  

Effect of totally extraperitoneal prosthesis and transperitoneal hernioplasty on spermatic vessels and testicular function in male patients with inguinal hernia

作　　者：王友华 周学鲁 张焕彬 WANG You-hua;ZHOU Xue-lu;ZHANG Huan-bin(Department of General Surgery,Chashan Hospital of Dongguan,Guangdong Province,Dongguan523000,China)

机构地区：[1]广东省东莞市茶山医院普外科,广东东莞523000

出　　处：《中国当代医药》2020年第30期96-98,102,共4页China Modern Medicine

基　　金：广东省东莞市社会科技发展(重点)项目(201950715009200)。

摘　　要：目的探讨腹腔镜下完全腹膜外补片植入术(TEP)和腹腔镜经腹腹膜前疝修补术(TAPP)对男性腹股沟疝患者精索血管及睾丸功能的影响。方法选取2016年1月~2019年1月我院收治的86例男性腹股沟疝患者作为研究对象,按照随机数字表法分为TEP组(43例)与TAPP组(43例),比较两组的手术和住院情况、两组患者手术前后精索血管和睾丸功能状况以及并发症发生情况。结果两组手术时间、术中失血量和住院时间比较,差异无统计学意义(P>0.05);术后4周,两组患者的精索动脉管径和血流速度比较,差异无统计学差异(P>0.05);TAPP组患者的精索静脉管径宽于TEP组,血流速度慢于TEP组,差异有统计学意义(P<0.05);术后4周,两组患者的精液量、精子密度、精子成活率和血清睾酮浓度比较,差异无统计学意义(P>0.05);两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论对于男性腹股沟疝患者,TEP和TAPP的有效性与安全性相当,对精索动脉和睾丸功能均无显著性影响,但TEP对患者精索静脉的影响相较TAPP更小。Objective To investigate the effect of laparoscopic totally extraperitoneal prosthesis(TEP)and laparoscopic transperitoneal hernioplasty(TAPP)on spermatic cord blood vessels and testicular function in male patients with inguinal hernia.Methods A total of 86 male inguinal hernia patients admitted to our hospital from January 2016 to January 2019 were selected as the research objects.According to the random number table method,they were divided into TEP group(43 cases)and TAPP group(43 cases).The operation and hospitalization,the function of spermatic blood vessels and testis before and after operation,and the complications were compared between the two groups.Results There were no significant differences in the length of operation,intraoperative blood loss and hospital stay between the two groups(P>0.05);4 weeks after surgery,there were no significant differences in the diameter and velocity of spermatic artery between the two groups(P>0.05);the diameter of spermatic vein in TAPP group was wider than that in TEP group,and the velocity of blood flow was slower than that in TEP group,and the differences were statistically significant(P<0.05);4 weeks after surgery,there were no significant differences between the two groups in semen volume,sperm density,sperm survival rate and serum testosterone concentration(P>0.05);there was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion For male inguinal hernia patients,the efficacy and safety of TEP and TAPP are comparable,and there is no significant effect on spermatic artery and testicular function,but the effect of TEP on spermatic vein is less than that of TAPP.

关 键 词：腹腔镜下完全腹膜外补片植入术 腹腔镜经腹腹膜前疝修补术 精索血管 睾丸功能 

分 类 号：R656.21[医药卫生—外科学]