摘要
目的探讨比较改良腹腔镜全腹膜外疝修补术(TEP)与开放疝修补术治疗腹股沟疝疗效及预后。方法回顾性分析95例腹股沟疝患者临床资料,按手术方式分为对照组(n=43)和观察组(n=52)。对照组给予开放性全腹膜外疝修补术治疗,观察组给予改良TEP治疗。观察比较两组手术时间、术后疼痛视觉模拟评分(VAS)、下床活动时间及住院时间等手术情况,术后并发症及复发情况。结果与对照组相比,观察组术后VAS评分明显降低,下床活动时间及住院时间显著缩短,比较差异均有显著性(均P<0.05),而手术时间两组间比较差异无显著性(P>0.05)。术后,观察组的并发症总发生率为13.5%,明显低于对照组30.2%的发生率,且观察组慢性疼痛发生率显著低于对照组,比较差异均有显著性(均P<0.05)。随访6个月,对照组和观察组的复发率分别为4.6%和5.8%,组间比较差异无显著性(P>0.05)。结论改良TEP是治疗腹股沟疝的一种安全有效手术方式,与开放性全腹膜外疝修补术相比,可以显著减轻患者术后疼痛,缩短下床活动时间及住院时间,并明显降低并发症发生率,且不增加疾病复发率,临床上值得进一步研究。
[Objective] To compare curative efficacy and prognosis of modified laparoscopic totally extraperitoneal prosthetic （TEP） and opening hernia repair in the treatment of inguinal hernia. [ Methods ] 95 cases of inguinal hernia meeting the inclusion criteria were divided into control group （n =43） and observation group （n = 52） according to operative method. The control group was given opening totally extraperitoneal prosthetic, and the observation group was given modified laparoscopic TEP. Then, operation situation of operation time, frequency of analgesics after the surgery, evacuation active time and hospitalization time, incidence of complications and recurrence rate were observed and compared. [Results ] The observation group had a statistically reduced frequency of analgesics, shorter evacuation active time and hospitalization time in comparison with the control group （all P 〈 0.05）, while the operation time in the two groups was statistically same （P 〉0.05）. After the surgery, the total incidence of complications in the observation group was 13.5%, which was statistically lower than that of 30.2% in the control group （P 〈0.05）. And cases with chronic pain in the observation group was statistically less than those in the control group （P 〈0.05）. During the six-month follow-up, the observation group had a recurrence rate of 5.8%,which was statistically same with that of 4.6% in the control group （P 〉0.05）. [ Conclusion] Modified TEP was an effective and safety operative method for inguinal hernia. In comparison with opening totally extraperitoneal prosthetic, it could significantly reduce frequency of analgesics after the surgery, shorten evacuation active time and hospitalization time, decrease incidence of complications with no increasing recurrence rate.
出处
《中国内镜杂志》
北大核心
2015年第5期513-516,共4页
China Journal of Endoscopy
关键词
改良腹腔镜全腹膜外疝修补术
开放性全腹膜外疝修补术
腹股沟疝
modified laparoscopic totally extraperitoneal prosthetic
opening totally extraperitoneal prosthetic
inguinal hernia
