腹腔镜经腹腹膜前疝修补术与开放无张力疝修补术治疗腹股沟疝的疗效比较  

Laparoscopic transabdominal preperitoneal repair versus open tension-free repair for inguinal hernia

作　　者：刘景平 万智恒[1] 李瑞斌[1] Liu Jingping;Wan Zhiheng;Li Ruibin(Department of General Surgery,the first affiliated Hospital,Baotou Medical College,Baotou 014010,China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院普外科一病区,包头014010

出　　处：《中华疝和腹壁外科杂志（电子版）》2020年第5期485-488,共4页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

基　　金：内蒙古包头市社会发展科技支撑项目(2016X1030-3-2)。

摘　　要：目的比较腹腔镜经腹腹膜前疝修补术(TAPP)与开放无张力疝修补术治疗腹股沟疝的临床疗效。方法选取2016年11月至2019年11月,包头医学院第一附属医院普外科一病区腹股沟疝住院患者209例,按照术式不同分为2组。试验组患者102例,行腹腔镜经腹腹膜前疝修补术;对照组患者107例,行开放式无张力疝修补术。观察记录2组患者的手术时间、术中出血量、术后住院时间及术后使用镇痛药物情况等指标,并进行对比分析。结果2组手术均获成功,试验组无中转开放手术。试验组与对照组比较,手术时间延长(46.87±4.94)min vs(38.40±4.29)min,术中出血量降低(5.40±1.64)ml vs(11.12±2.09)ml,术后住院时间减少(4.18±1.09)d vs(5.08±1.58)d,术后使用镇痛药和疼痛评分均减少,差异均有统计学意义(均P<0.05)。术后随访均恢复良好,随访时间为6~42个月,2组患者均未复发,无明显术后并发症发生。结论TAPP治疗腹股沟疝与开放式无张力疝修补术相比,具有微创、安全有效、无明显瘢痕等特点,是临床上可靠的治疗腹股沟疝选择之一。Objective To compare the clinical efficacy of laparoscopic transabdominal preperitoneal(TAPP)herniorrhaphy and open tension-free repair for inguinal hernia.Methods Randomly select 209 cases of inguinal hernia in the first affiliated hospital of Baotou medical college from November 2016 to November 2019.The patients were divided into two groups.Of the patients,102 cases received laparoscopic TAPP repair(experimental group)and 107 cases underwent open tension-free repair(control group).The operation time,intraoperative blood loss,postoperative hospital stay,postoperative pain degree were observed and recorded in two groups.Results The two groups of operation were successful,there were no conversion to open operation in experimental group.Compared with the control group,the operation time of the experimental group was significantly longer than the control group(46.87±4.94)min vs(38.40±4.29)min;intraoperative blood loss(5.40±1.64)ml vs(11.12±2.09)ml and length of hospital stay(4.18±1.09)d vs(5.08±1.58)d were reduced(all P<0.05);The postoperative pain score and the use of analgesic were reduced(all P<0.05).All patients recovered well after operation.The follow-up time was from 6 months to 42 months.There was no recurrence and no obvious postoperative complications in both groups.Conclusion For inguinal hernia,the transabdominal preperitoneal(TAPP)herniorrhaphy is less invasive compared with open tension-free repair technique,and is also safe and reliable,no obvious scar was formed.So it is a favorable treatment option in clinical practice.

关 键 词：疝 腹股沟 疝修补术 腹腔镜 

分 类 号：R656.21[医药卫生—外科学]