免气腹腹腔镜全腹膜外腹股沟疝修补术初步体会

目的探讨免气腹装置在腹腔镜全腹膜外腹股沟疝修补术（totally extraperitone alapproach,TEP）中的应用价值。方法2007年4～8月,行免气腹TEP30例,同期行气腹TEP52例。对比2组手术时间、住院费用、并发症、住院时间及随访结果。结果与气腹组相比,免气腹组手术时间长[（65.3±19.4）minvs（43.6±21.9）min,t=4.501,P=0.000],但住院费用少[（6186.7±1283.7）元vs（8391.8±850.8）元,t=-9.347,P=0.000]。2组并发症发生率[6.7%（2/30）,vs5.8%（3/52）,χ^2=0.027,P=0.870]和住院时间[（2.1±0.8）dvs（1.8±0.9）d,t=1.513,P=0.134]差异无显著性。2组随访3～7个月,均无复发。结论免气腹TEP有一定的安全性和可操作性,具有TEP补充应用的价值。

Primary Report on Gasless Laparoseopy for Totally Extraperitoneal Hernia Repair

Objective To evaluate the efficacy of gasless laparoscopy for totally extraperitoneal（TEP） hernia repair.Methods Between April and August 2007,totally 82 patients with inguinal hernia received TEP in our hospital,in 30 of them the surgery was completed with gasless laparoscopy,while in the other 52,pneumoperitoneum was used for the operation.The operation time,medical cost,hospital stay,complications,and follow-up data of the two groups were compared.Results The gasless group had a longer operation time [（65.3±19.4） min vs（43.6±21.9） min,t=4.501,P=0.000],but less medical cost [（6186.7±1283.7） RMB vs（8391.8±850.8） RMB,t=-9.347,P=0.000].No significantly difference was observed in the hospital stay and rate of complications between the two groups [（2.1±0.8） d vs（1.8±0.9） d,t=1.513,P=0.134;and 6.7%（2/30） vs 5.8%（3/52）,χ^2=0.027,P=0.870].Conclusion Gasless laparoscopy is effective and safe for totally extraperitoneal（TEP） hernia repair.