不同平台入路单孔腹腔镜经腹腹膜前腹股沟疝修补术的对照研究  

A control study of different platform approaches in single port laparoscopic transabdominal preperitoneal inguinal hernia repair

作　　者：房鑫[1] 李文浩 王静[2] 牛亮 吴卫东[3] FANG Xin;LI Wenhao;WANG Jing(The Second Department of General Surgery,Linzi District Maternal and Child Health Hospital,Qidu Hospital,Zibo 255400,China;Department of Gastrointestinal Surgery,Zibo Central Hospital)

机构地区：[1]临淄区妇幼保健院齐都医院普外二科,山东淄博255400 [2]淄博市中心医院胃肠外科 [3]上海交通大学医学院附属第一人民医院,上海市第一人民医院胃肠外科

出　　处：《腹腔镜外科杂志》2024年第11期853-857,863,共6页Journal of Laparoscopic Surgery

基　　金：淄博市医药卫生科研项目(20230401038)。

摘　　要：目的:对比分析筋膜平台与Port平台在单孔腹腔镜经腹腹膜前腹股沟疝修补术(SIL-TAPP)中的应用效果,探寻SIL-TAPP适用的通道。方法:选择2021年6月至2023年12月由固定团队施行的154例SIL-TAPP,其中筋膜平台组81例,Port平台组73例,收集两组患者术前、术中资料,术后随访3~12个月,观察远期并发症情况。结果:两组患者术前资料差异无统计学意义,Port平台组手术时间[(62.03±8.60)min vs.(57.01±8.41)min]、建立通道时间[(8.16±2.27)min vs.(2.66±0.73)min]、缝合腹膜时间[(12.27±2.14)min vs.(11.40±1.06)min]长于筋膜平台组(P<0.05),两组术中出血量差异无统计学意义。筋膜平台组出现脐部皮下出血9例(11.1%),Port平台组无出血发生,两组差异有统计学意义。两组术后24 h疼痛视觉模拟评分、血清肿发生率、术后住院时间差异无统计学意义。术后两组均无感染、复发及慢性疼痛发生。结论:两种入路行SIL-TAPP均是安全、有效的,筋膜平台具有更好的手术流畅度与操作精准性。Objective:To compare and analyze the application effect of fascial platform and Port platform in single-incision la-paroscopic transabdominal preperitoneal inguinal hernia repair(SIL-TAPP),and identify the optimal access technique for SIL-TAPP.Methods:From Jun.2021 to Dec.2023,a total of 154 SIL-TAPP procedures performed by a fixed surgical team were retrospectively a nalyzed.The cases were divided into the fascial platform group(n=81)and the Port platform group(n=73).Preoperative,intraope-rative,and postoperative data were collected,with follow-up ranging from 3 to 12 months to evaluate long-term complications.Results:There was no statistically significant difference in preoperative characteristics between the two groups.The Port platform group had longer operative time[(62.03±8.60)min vs.(57.01±8.41)min],channel creation time[(8.16±2.27)min vs.(2.66±0.73)min],and peritoneal suturing time[(12.27±2.14)min vs.(11.40±1.06)min]compared with the fascial platform group.Intraoperative blood loss was comparable between the two groups.Subcutaneous umbilical hematoma occurred in 9 cases(11.1%)in the fascial platform group,while no cases were observed in the Port platform group,showing statistically significant difference.No significant diffe-r ences were found between the two groups in 24 h postoperative pain visual analogue scores,incidence of seroma,or postoperative hospital stay.No infections,recurrences,or chronic pain were reported in either group during follow-up.Conclusions:Both fascial and Port platform approaches are safe and effective for SIL-TAPP.The fascial platform demonstrates better procedural fluency and surgical precision.

关 键 词：疝 腹股沟 疝修补术 经腹腹膜前 腹腔镜检查 单孔 筋膜平台 操作平台 

分 类 号：R656.21[医药卫生—外科学]