摘要
目的：比较腹腔镜下经腹腹膜前疝修补术（TAPP）与平片式无张力疝修补术（Lichtenstein术）治疗成年人腹股沟复发疝的临床疗效，探讨TAPP治疗腹股沟复发疝的临床优势。方法回顾性分析2010年12月至2015年1月寿光市人民医院普外科及潍坊市人民医院胃肠外科收治的54例成人腹股沟复发疝患者，根据治疗方法不同分为TAPP组和Lichtenstein组，比较两组患者手术时间、术中出血量、术后住院时间、住院费用、术后并发症、术后疼痛及疝复发等的差异。结果所有患者均顺利完成手术，TAPP组手术时间（47．2±9.4）min，明显短于Lichtenstein组的（73．1±10．4）min（t＝－2．503，P＝0．034），术中出血量中位数40（15～110）mL，明显少于Lichtenstein组的73（11～130）mL（t＝－6．018，P＝0．000），术后住院时间（6．5±1．4）d，短于Lichtenstein组的（8．2±1．6）d（t＝－2．613，P＝0．028），术后早期疼痛评分（1．8±1．2）分，优于Lichtenstein组的（2．9±1．4）分（t＝－7．006，P＝0．000），差异均有统计学意义（均P＜0．05）；TAPP组住院期间费用（8842．8±415．2）元，高于Lichtenstein组的（6676．9±327．6）元，差异有统计学意义（t＝6．782，P＜0．05）。TAPP组术后2例出现并发症，少于Lichtenstein组的5例；术后随访6～48个月，Lichtenstein组1例复发，复发率为3．8％，TAPP组无复发。结论 TAPP治疗成年人腹股沟复发疝具有手术时间短、术中出血少、术后恢复快、术后疼痛轻等优点，可作为治疗成年人腹股沟复发疝的推荐手术方式。
Objective To compare the clinical efficacy of laparoscopic repair of laparoscopic transabdominal preperitoneal（TAPP）and Lichtenstein tension-free repair herniorrhaphy in the treatment of recurrent inguinal hernia in adults,and to explore the clinical advantages of TAPP in the treatment of recurrent inguinal hernia.Methods A retrospective analysis was conducted in 54 adult patients with recurrent inguinal hernia from December 2010 to January 2015.The patients were randomly divided into TAPP group and Lichtenstein group.The operation time,intraoperative bleeding volume,postoperative hospitalization time,cost of hospitalization,postoperative complications,early postoperative pain and the recurrence of hernia were compared between the two groups.Results All patients were successfully completed surgery.The operation time of TAPP group （47.2 ±9.4）min was significantly shorter than （73.1 ±10.4）min of Lichtenstein group （t=-2.503,P=0.034）.The median amount of bleeding during operation of TAPP group was 40（15 -110）ml,which was significantly less than 73（11 -130）ml in Lichtenstein group （t=-6.018,P=0.000）. Postoperative hospital stay of TAPP group[（6.5 ±1.4）d]was shorter than （8.2 ±1.6）d of the Lichtenstein group （t=-2.613,P=0.028）.Early postoperative pain score of TAPP group[（1.8 ±1.2）points]was better than （2.9 ± 1.4）points in Lichtenstein group （t=-7.006,P=0.000）,the difference was statistically significant.However,the hospitalization cost of TAPP group[（8 842.8 ±415.2）yuan]was higher than （6 676.9 ±327.6）yuan of the Lichtenstein group,the difference was statistically significant（t=6.782,P〈0.05）.In TAPP group,2 cases had complications after＆amp;nbsp;operation,which were less than 5 cases of Lichtenstein group.Postoperative follow up ranged from 6 to 48 months,1 case of recurrence in Lichtenstein group,the recurrence rate was 3.8%.There was no recurrence in the TAPP group.Conclusion TAPP has the advantages of short operation time,less bleeding,rapid postoperative recovery,less postoperative pain and so on.It can be used as a recommended procedure for the treatment of recurrent inguinal hernia in adults.
出处
《中国基层医药》
CAS
2017年第3期351-354,共4页
Chinese Journal of Primary Medicine and Pharmacy
基金
山东省潍坊市卫生和计划生育委员会科研计划项目（2016wsjs035）
关键词
疝
腹股沟
腹腔镜
经腹腹膜前疝修补术
平片式无张力疝修补术
复发
Hernia,inguinal
Laparoscopy
Transabdominal preperitioneal laparoscopic herniorrhaphy
Path tension-free hernioplasty
Recurrence
