摘要
目的探讨腔镜下腹腔内植入式腹股沟疝修补术(IPODM)新术式在临床应用上的可行性及与开放无张力腹股沟疝修补术(NTHP)及经腹腔腹膜前网片修补术(TAPP)、腹腔内补片植入术(IPOM)、完全前腹膜间隙补片修补术(TEP)的可比性。方法将实验组167例采用IPODM的病例按病种、手术方式、术后恢复情况分组研究,对照组167例均为开放无张力腹股沟疝修补术并采用相同分组。结果实验组167例在腔镜下成功完成手术,平均手术时间11.35min(不计麻醉时间),对照组平均手术时间为41.26min(P<0.001);实验组术后当天下床活动并进食者161例,对照组42例(P<0.001);实验组术后第一天有低热者15例,对照组45例(P<0.001);实验组术后留院最短2d,最长7d,对照组最短5d,最长为8d;实验组术后平均住院日为2.98d,对照组为5.88d(P<0.001);实验组术中、术后无一例并发症(无术后肠梗阻),追踪4年有1例复发,对照组有5例复发。结论IPODM是集开放无张力腹股沟疝修补术式及TAPP、IPOM、TEP的优点、弥补其缺点为一体的可行性术式,它简便易行、易推广,有较深远的临床价值。
Objective To compare the difference between laparoscopic inguinal herniorhaphy with intraperitoneal onlay (IPODM) and open non-tension herniorrhaph (NTHP). Method One hundred and sixty-seven cases of inguinal hernia were treated with IPODM, and 167 cases were treated with NTHP as control group. Result The average time of operation in IPODM group (11.35 minutes) was significantly shorter than that of control group (41.26 minutes),P<0.001; the average stay in hospital postoperation (2.98 days) was significantly shorter than that of control group (5.88 days),P<0.001; there was one case recurrence in IPODM group,but 5 cases in control group within 4 years. Conclusion The IPODM is a new kind style operation with virtue of simple and convenient, which is with profound clinical value.
