自固定补片"Y形"铺置法在女性腹股沟疝经腹腹膜前修补术中的应用  

Application of self fixing mesh with"Y-shaped"placement in laparoscopic transabdominal preperitoneal repair of inguinal hernia of female inguinal hernia

作　　者：田利飞 郑波波 耿西林[2] 杨文滨 王小强[1] Tian Lifei;Zheng Bobo;Geng Xilin;Yang Wenbin;Wang Xiaoqiang(Department of General Surgery I Section,Shaanxi Provincial People′s Hospital,Xi′an 710068,China;Department of Hepatobiliary Surgery,Shaanxi Provincial People′s Hospital,Xi′an 710068,China;Department of Breast and Thyroid Surgery,Northwest Women′s and Children′s Hospital,Xi′an 710061,China)

机构地区：[1]陕西省人民医院普外一科,西安710068 [2]陕西省人民医院肝胆外科,西安710068 [3]西北妇女儿童医院乳甲外科,西安710068

出　　处：《中国综合临床》2021年第4期344-348,共5页Clinical Medicine of China

摘　　要：目的探讨自固定补片"Y"形铺置法在腹腔镜女性腹股沟疝经腹腹膜前修补术(laparoscopic transabdominal preperitoneal repair of inguinal hernia,TAPP)中的效果。方法选取2019年2月至2020年9月陕西省人民医院行腹腔镜TAPP手术(keyhole法)的女性腹股沟疝患者共40例,采用前瞻性队列研究,依据补片铺置方法的不同分为"Y"形铺置法组21例、常规法组19例,比较两组患者手术时间、补片铺置时间、术后住院时间、术后1 d的VAS评分及术后并发症情况。结果40例患者均完成TAPP手术,所有患者均顺利完成随访,中位随访时间12.5个月。"Y"形铺置法组手术时间及补片铺置时间分别为(54.9±9.0)、(10.8±2.5)min,常规法组分别为(62.8±11.2)、(20.3±3.5)min;两组比较差异均有统计学意义(t=2.490、P=0.017;t=9.925、P<0.001)。两组患者术后住院时间、术后1 d VAS评分、术后并发症比较差异均无统计学意义(P均>0.05)。结论在腹腔镜女性腹股沟疝修补术(keyhole法)中,"Y"形铺置法可有效缩短自固定补片铺片时间,从而缩短手术时间,且并不增加并发症的风险,具有一定优势。Objective To investigate the effect of self fixing mesh with"Y-shaped"placement in laparoscopic transabdominal preperitoneal repair of female inguinal hernia.Methods From February 2019 to September 2020,a total of 40 female patients who underwent TAPP(Keyhole method)in Shaanxi Provincial People′s Hospital were researched.Random number table method was used.According to different patch placement methods,the patients were divided into the self fixing mesh with"Y-shaped"placement group(21 cases)and with normal placement group(19 cases).The operative time,placement time,length of stay,Visual Analogue Scale(VAS),postoperative complication were compared between two groups.Results All 40 patients completed TAPP,and all patients were followed up successfully,with a median follow-up time of 12.5 months.The operation time and patch placement time were(54.9±9.0)min and(10.8±2.5)min in the Y-shaped placement method group and(62.8±11.2)min and(20.3±3.5)min in the conventional placement method group,respectively;the differences between the two groups were statistically significant(t=2.490,P=0.017;t=.925,P<0.001).There was no statistically significant difference between the two groups in length of stay,VAS score 1 day after surgery and postoperative complications(all P>0.05).Conclusion In laparoscopic female inguinal hernia repair(keyhole method),the"Y"shape placement method can effectively shorten the time of self fixing patch placement,thus shorten the operation time,and does not increase the risk of complications.

关 键 词：腹股沟疝 腹腔镜 自固定补片 女性 

分 类 号：R656.21[医药卫生—外科学]