摘要
目的 比较开腹无张力填充式腹股沟疝修补术与两种腹腔镜腹股沟疝修补术的疗效.方法 将患有单侧原发性腹股沟疝的患者术前随机分成3组：开腹无张力填充式腹股沟疝修补术（开腹疝修补术）组或腹腔镜经腹腔腹膜前腹股沟疝修补术（transabdominal preperitoneal hernioplasty,TAPP）组或腹腔镜完全腹膜外腹股沟疝修补术（totally extraperitoneal hernioplasty,TEP）组,将临床资料进行对比研究.结果 2006年2月至2009年2月收住院的164例患者参加本研究,其中62例行开腹疝修补术、50例行TAPP、52例行TEP.平均随访（16±8）个月.开腹疝修补术组的平均手术时间明显短于两种腹腔镜手术组（P＜0.01）;住院费用也明显低于腹腔镜组（P＜0.01）.而开腹疝修补术组的术后疼痛评分明显高于两种腹腔镜手术组（P＜0.01）;术后住院时间及完全恢复时间也明显长于腹腔镜组（P＜0.01）.3组均无手术严重并发症及术后复发.结论本研究证明三种疝修补术治疗单侧原发性腹股沟疝是安全有效的.TAPP和TEP,术后疼痛轻、恢复快,是值得推荐的外科术式.
Objective To evaluate the effectiveness and safety of open tension-free hernioplasty and two kind of laparoscopic hernia repair for the treatment of primary unilateral inguinal hernia. Methods Patients suffering from primary unilateral inguinal hernia were randomly divided into 3 groups to undergoopen operation with mesh-plug and patch or transabdominal preperitoneal hernioplasty （TAPP） or totally extraperitoneal hernioplasty （ZEP）. Results From February 2006 to February 2009, a total of 164patients were divided into 3 groups, with 62 undergoing open tension-free mesh-plug hernia repair, 50receiving TAPP and 52 receiving TEP. Postoperative patients were then followed up for a period of（16±8）months. The average operating time for the patients in the open mesh repair group was significantly shorter compared to the other two groups （P〈0.01 ）. The cost in the open mesh repair group was also significantly lower than the other two groups （P〈0.01）. The pain scores in open mesh group were significantly higher than those in the other two groups （P〈0.01）. The hospital stay and the recovery time were both significantly longer in the open mesh repair group （P〈0.01） compared to the other two groups. No major complications and recurrence was found in neither groups. Conclusions Open tension-free mesh-plug hernia repair, TAPP and TEP are all safe and effective for the treatment for patients with primary unilateral inguinal hernia. TAPP and TEP are superior to open tension-free mesh-plug hernia repair as these two procedures involve less postoperative pain and fast recovery.
出处
《中华普通外科杂志》
CSCD
北大核心
2010年第12期966-968,共3页
Chinese Journal of General Surgery
关键词
疝
腹股沟
外科手术
病例对照研究
腹腔镜
Hernia, inguinal
Surgical procedures, operative
Case-control studies
Laparoscopes
