腹腔镜下经腹腹膜前疝修补术与平片式无张力疝修补术在双侧腹股沟疝治疗中的应用疗效  

Comparison of transabdominal preperitoneal prosthesis and flat plate tension-free hernia repair operation in the repair of bilateral inguinal hernia

作　　者：李东方 蔡德珺[2] 陈泳汉 蒋晓松[2] LI Dongfang;CAI Dejun;CHEN Yonghan;JIANG Xiaosong(Surgery Department of Qiaoli Hospital of Traditional Chinese Medicine,Doumen District,Zhuhai City,Doumen Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangdong Zhuhai 519125,China;Surgery Department of Zhuhai Hospital,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangdong Zhuhai 519015,China)

机构地区：[1]珠海市斗门区侨立中医院广东省中医院斗门医院外一科,广东珠海519125 [2]广东省中医院珠海医院外一科,广东珠海519015

出　　处：《临床普外科电子杂志》2023年第3期42-48,共7页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的探讨腹腔镜下经腹腹膜前疝修补术(transabdominal preperitoneal prosthesis,TAPP)对比平片式无张力疝修补术(Lichtenstein术)在双侧腹股沟疝修补中的疗效。方法回顾性分析2019年1月至2022年4月珠海市斗门区侨立中医院收治住院的双侧腹股沟疝患者75例,其中40例予以Lichtenstein术治疗,35例予以TAPP治疗。比较两组患者围手术期情况、短期治疗效果、复发率及并发症发生率。结果TAPP组患者的手术时间长于Lichtenstein组,术后24h疼痛评分低于Lichtenstein组,且术后下床时间、术后排气时间及住院时间均明显短于Lichtenstein组,住院费用高于Lichtenstein组,差异均有显著性(P<0.05)。术后1d,TAPP组白细胞计数[(4.98±1.02)×10^(9)/L]、肿瘤坏死因子-α[(35.13±4.52)pg/L]和C反应蛋白[(3.78±0.62)mg/L]均低于Lichtenstein组[分别为(5.63±1.38)×10^(9)/L、(42.17±4.31)pg/L和(4.83±0.70)mg/L],差异有显著性(P<0.05)。TAPP组患者认可度为91.43%,高于Lichtenstein组患者认可度(85.00%),但组间无显著差异(P>0.05)。TAPP组患者出现并发症3例,总发生率为8.5%;Lichtenstein组患者出现并发症6例,总发生率为15.0%,组间无显著差异(P>0.05)。所有患者术后均随访19个月,TAPP组有2例(5.71%)分别于术后7个月及17个月复发;Lichtenstein组有1例(2.50%)于术后13个月后复发,两组患者术后复发率无显著差异(P>0.05)。结论TAPP与Lichtenstein术对双侧腹股沟疝的临床疗效确切,并发症发生率相当,但TAPP治疗的患者术后恢复更快。Objective To investigate the efficacy of transabdominal preperitoneal prosthesis(TAPP)versus flat plate tension-free hernia repair(Lichtenstein)surgery in bilateral inguinal hernia repair.Method A retrospective analysis of 75 patients with bilateral inguinal hernia admitted to the hospital from January 2019 to April 2022,of which 40 were treated with Lichtenstein surgery and 35 were treated with TAPP.The perioperative condition,shortterm treatment effect,recurrence rate and complication rate of the two groups were compared.Result The surgical time in the TAPP group was higher than that in the Lichtenstein group,The postoperative 24-hour pain score,postoperative bedtime,postoperative exhaust time,and hospital stay in the TAPP group were significantly lower than those in the Lichtenstein group,The hospitalization expenses of the TAPP group were higher than those of the Lichtenstein group,the differences are significant(P<0.05).On the 1st postoperative day,white blood cell count in the TAPP group was(4.98±1.02)×10^(9)/L,tumor necrosis factor-α lever was(35.13±4.52)pg/L,and C-reactive protein lever was(3.78±0.62)mg/L,which were all lower than those in the Lichtenstein group[(5.63±1.38)×10^(9)/L,(42.17±4.31)pg/L,and(4.83±0.70)mg/L,respectively],the differences are significant(P<0.05).The recognition rate of patients in the TAPP group was 91.43%,higher than that in the Lichtenstein group(85.00%),but there was no statistically significant difference between the groups(P>0.05).3 patients in the TAPP group experienced complications,with a total incidence rate of 8.5%;6patients in the Lichtenstein group experienced complications,with a total incidence rate of 15.0%.There was no statistically significant difference between the two groups(P>0.05).All cases were followed up for 19 months after surgery,In the TAPP group,2 cases(5.71%)recurred at 7 and 17 months respectively;1 case(2.50%)in the Lichtenstein group relapsed 13 months after surgery.There was no statistically significant difference in the recurrence rate b

关 键 词：经腹腹膜前疝修补术 平片式无张力疝修补术 腹股沟疝 疗效 

分 类 号：R65[医药卫生—外科学]