腹腔镜全腹膜外腹股沟疝修补术日间手术模式临床应用研究  

Study on the clinical application of laparoscopic total extraperitoneal inguinal hernia repair day surgery mode

作　　者：钟春林[1] 罗丹 于颖娟[1] 杨可 周燕[1] 张梅[1] 刘文[1] Chunlin Zhong;Dan Luo;Yingjuan Yu;Ke Yang;Yan Zhou;Mei Zhang;Wen Liu(Department of General Surgery,Mianyang Central Hospital,Sichuan Province,Mianyang 621000,Sichuan,China)

机构地区：[1]四川省绵阳市中心医院普外科,621000

出　　处：《中华疝和腹壁外科杂志（电子版）》2024年第1期45-49,共5页Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)

摘　　要：目的全腹膜外腹腔镜腹股沟疝修补术(TEP)是目前临床治疗腹股沟疝的主要手术方式之一,本文旨在探讨TEP手术在日间手术模式的安全性及有效性。方法回顾性分析2022年6月至2023年6月,绵阳市中心医院行日间腹股沟疝手术患者的临床资料,依据手术方式将患者分为开放组(开放腹膜前修补手术236例)、TEP组(124例)。分析对比2组患者手术相关指标(手术时间、术中出血量、术后下床活动时间、切口愈合时间、住院费用)、并发症(尿潴留发生率、阴囊积液发生率、异物感、慢性疼痛、切口感染、术区积液及总并发症发生率)、就医满意度及术后6个月复发情况。结果所有患者均顺利完成手术,TEP组无中转。单侧腹股沟疝手术时间开放组优于TEP组,双侧腹股沟疝手术时间,2组比较差异无统计学意义。2组患者术中出血量比较差异无统计学意义(P>0.05),TEP组下床活动时间、切口愈合时间明显优于开放组[(4.5±2.4)h vs(6.9±1.5)h;(8.5±1.7)d vs(11.2±2.3)d],住院费用高于开放组,差异均有统计学意义(P<0.05)。2组患者术后尿潴留、阴囊积液、术区积液及总并发症发生率比较,差异无统计学意义(P>0.05);开放组术区异物感及切口感染发生率高于TEP组,差异有统计学意义(P<0.05)。术后3个月TEP组患者整体满意度明显优于开放组(95.1%vs 90.2%),差异有统计学意义(P<0.05)。2组患者术后随访6个月,除开放组2例失访外,经超声检查均无复发病例。结论TEP在日间手术模式下安全有效,可在熟练掌握后应用。Objective Total extraperitoneal laparoscopic inguinal hernia repair(TEP)is one of the main surgical methods for treatment of inguinal hernia.The purpose of this paper is to explore the safety and effectiveness of TEP surgery in the day surgery mode.Methods The clinical data of patients undergoing inguinal hernia day surgery in Mianyang Central Hospital from June 2022 to June 2023 were retrospectively analyzed.They were divided into the open group(236 cases of open preperitoneal repair)and the TEP group(124 cases)by surgical methods.The operation indexes(operation time,intraoperative blood loss,postoperative ambulation time,the time of incision healing,hospitalization cost),complications(urinary retention,scrotal effusion,foreign body sensation,chronic pain,infection of incision,operated region effusion,and total complication rate),satisfaction,and recurrence 6 months after surgery were analyzed and compared between the two groups.Results All patients successfully completed the operation,and there was no conversion in the TEP group.The operation time of unilateral inguinal hernia in the open group was shorter than in the TEP group.There was no statistically significant difference in the surgical time for bilateral inguinal hernia between the two groups of patients.There was no significant difference in intraoperative blood loss between the two groups.The time of getting out of bed and the time of incision healing were significantly shorter in the TEP group than those of the open group[(4.5±2.4)hours vs(6.9±1.5)hours;(8.5±1.7)days vs(11.2±2.3)days],and the difference was statistically significant(P<0.05).The hospitalization cost of the TEP group was higher than that of the open group(P<0.05).There was no significant difference in incidence of postoperative urinary retention,scrotal effusion,chronic pain,operated region effusion,and total complication rate between the two groups of patients(P>0.05).The incidence of foreign body sensation and incision infection in the open group was higher than in the TEP group(P

关 键 词：腹腔镜 疝 腹股沟 疝修补术 日间手术 满意度 

分 类 号：R656.21[医药卫生—外科学]