摘要
目的 探讨自膨式Kugel补片在老年复发性腹股沟疝中的应用价值. 方法 对2004年2月～2007年2月37例老年复发性腹股沟疝病例按手术方式分为两组.Kugel组21例,其中单侧斜疝17例,双侧斜疝1例,直疝1例,斜疝合并股疝1例,斜疝合并直疝1例,均采用美国巴德Kugel补片后入路修补;TAPP组(腹腔镜经腹腹膜前补片植入术)16例,其中单侧斜疝15例,直疝1例. 结果 Kugel组手术时间短于TAPP组[(23.2±5.8)min和(40.5±5.2)min,t=-9.392,P=0.000)].Kugel组无手术区疼痛或牵拉感,TAPP组有2例(χ2=0.869,P=0.351).术后住院时间Kugel组较短[(5.7±0.7)d和(6.3±0.8)d,t=-2.429,P=0.020].两组术后随访3～36个月,无一例复发. 结论 Kugel补片后入路修补术是治疗老年复发性腹股沟疝的一种全新、无张力、安全、微创、优势显著的方法,值得推广.
Objective To investigate the value of Kugel patch for elderly patients with recurrent inguinal hernia.Methods From February 2004 to February 2007,37 elderly patients with recurrent inguinal hernia received surgical treatment in our hospital.The patients were divided into two groups according to the surgical methods.Twenty-one patients,including 17 cases of unilateral indirect inguinal hernia,1 bilateral indirect hernia,1 direct hernia,1 indirect hernia complicated with femoral hernia,and 1 indirect hernia complicated with direct hernia,received hernia repair with Kugel patch via the posterior approach.The other 16 patients,including 15 cases of unilateral indirect hernia and 1 case of direct hernia,were treated with TAPP.Results The operation time in the Kugel group was significantly shorter than that in the TAPP group [(23.2±5.8) min vs(40.5±5.2) min,t=-9.392,P=0.000].In the TAPP group,2 patients complained of surgical-site pain or tension,while no patient in the Kugel group had the symptoms(χ2=0.869,P=0.351).The mean hospital stay in the Kugel group was shorter than that in the TAPP group [(5.7±0.7)d vs(6.3±0.8) d;t=-2.429,P=0.020].The patients were followed up for 3-36 months,none of them had recurrence.Conclusions As an new,non-tension,safe,and minimally invasive method,hernia repair using Kugel patch through the posterior approach is of great advantage to elderly patients.The method is worth being used widely.
出处
《中国微创外科杂志》
CSCD
2007年第12期1144-1146,共3页
Chinese Journal of Minimally Invasive Surgery
