完全腹膜外腹股沟疝修补术中探查对侧腹股沟区必要性的相关研究  

Study on the necessity of exploring contralateral inguinal region during total extraperitoneal inguinal hernia repair

作　　者：黄壮生[1] 林玉海 郑淋旭 方喜[1] 李颖[1] HUANG Zhuang-sheng;LIN Yu-hai;ZHENG Lin-xu;FANG Xi;LI Ying(Department of General Surgery,Shantou Central Hospital,Shantou 515000,Guangdong,China)

机构地区：[1]汕头市中心医院普外科,广东汕头515000 [2]汕头市卫生学校,广东汕头515000

出　　处：《广东医学》2023年第4期509-513,共5页Guangdong Medical Journal

基　　金：汕头市科技计划项目(191220175262981)。

摘　　要：目的探讨在进行完全腹膜外腹股沟疝修补术(TEP)时对对侧腹股沟区探查的必要性.方法回顾性分析2018年1月至2022年3月142例单侧腹股沟疝患者临床资料,依据手术方法的不同,按术中有无进行对侧腹股沟区探查,分为研究组71例(双腹腔镜TEP)和对照组71例(TEP).对比两组患者手术时间、术中出血量、住院费用、术后住院时间、对侧隐匿疝发现情况、术后并发症发生率.结果研究组手术时间为(95.35±32.25)min,对照组为(90.63±28.28)min,两组患者手术时间差异无统计学意义(t=0.927,P=0.356).研究组术中出血量为(6.87±5.38)mL,对照组为(7.03±4.51)mL,两组差异无统计学意义(t=-0.186,P=0.853).研究组住院费用为(18733.19±3655.51)元,高于对照组的(17063.71±1270.63)元,差异有统计学意义(t=3.635,P<0.001).研究组术后住院时间为(1.89±0.78)d,对照组为(1.73±0.77)d,两组差异无统计学意义(t=1.185,P=0.238).研究组术后并发症发生率为7%,而对照组为5.6%,两组差异无统计学意义(χ^(2)=0.119,P=0.731).研究组术中探查出对侧隐匿疝17例.两组均随访至2022年5月,研究组未发现对侧腹股沟疝,而对照组患者在随访过程中有6例患者发现了对侧腹股沟疝,两组患者差异有统计学意义(χ^(2)=6.265,P=0.012).结论TEP术中探查对侧腹股沟区极为必要,有利于提高隐匿疝的检出率,减少术后对侧疝发生率,从而降低再次手术率,有着良好临床应用价值.Objective To explore the necessity of contralateral groin exploration in total extraperitoneal(TEP)inguinal hernia repair.Methods The clinical data of 142 patients with unilateral inguinal hernia who were treated in the Department of general surgery of Shantou Central Hospital from January 2018 to March 2022 were retrospectively analyzed.They were divided into the study group(71 cases)and the control group(71 cases)according to the surgical methods.The operation time,intraoperative bleeding,hospitalization cost,postoperative hospital stay,contralateral concealed hernia and postoperative complication rate were compared between the two groups.Results The operation time was(94.23±35.29)min in the study group and(90.63±28.28)min in the control group.There was no significant difference between the two groups(t=0.927,P=0.356).The intraoperative bleeding in the study group was(6.87±5.38)mL,and that in the control group was(7.03±4.51)mL,with no significant difference between them(t=-0.186,P=0.853).The hospitalization cost of the study group was(18733.19±3655.51)RMB and that of the control group was(17063.71±1270.63)RMB,with significant difference between them(t=3.635,P<0.001).The postoperative hospital stay was(1.89±0.78)days in the study group and(1.73±0.77)days in the control group,with no significant difference(t=1.185,P=0.238).The incidence of postoperative complications was 7%in the study group and 5.6%in the control group,with no significant difference(χ^(2)=0.119,P=0.731).During the operation,17 cases of contralateral concealed hernia were detected in the study group.The two groups were followed up until May 2022,there was no contralateral inguinal hernia occur in the study group;but in the control group,there were 6 persons occur contralateral inguinal hernia.The difference was statistically significant(χ^(2)=6.265,P=0.012).Conclusion Intraoperative exploration of the contralateral inguinal area is extremely necessary,which is beneficial to improve the detection rate of concealed hernia,reduce the incid

关 键 词：腹股沟疝 腹腔镜 对侧探查 隐匿疝 

分 类 号：R656.21[医药卫生—外科学] R605[医药卫生—临床医学]