腹腔镜与传统开放修补术治疗超重与肥胖患者腹壁切口疝的对比分析

目的探讨腹腔镜与传统开放修补术治疗超重与肥胖患者腹壁切口疝的临床疗效。方法回顾性分析2007年4月至2015年10月收治的45例超重和肥胖的腹壁切口疝患者的临床资料,其中腹腔镜手术组24例,传统开放手术组21例。比较两组患者的一般资料和手术相关情况。所得数据采用SPSS 19.0统计学软件进行处理。手术时间、住院时间、术中出血量、术后疼痛评分情况等计量数据用(x珋±s)表示,采用t检验;术后切口并发症发生率和复发率等计数资料用率表示,采用χ~2检验;P0.05为差异有统计学意义。结果腹腔镜手术组手术时间(76±19.3)min、住院时间(7.4±2.3)d、术中出血量(23±9.5)ml均少于传统开放手术组(96±21.2)min、(9.1±1.2)d和(185±32.4)ml(t=3.291,t=3.162,t=22.892,P均0.05);术后疼痛程度(3.0±0.8)低于传统开放手术组(6.3±0.9)(t=12.073,P0.05);术后切口并发症发生率低于传统开放手术组(χ~2=5.017,P0.05);但两组患者在复发率方面无明显差异(χ~2=1.416,P0.05)。结论腹腔镜修补术治疗超重与肥胖腹壁切口疝患者手术创伤小、术后恢复快,切口并发症少,值得提倡。

Comparative analysis of laparoscopic and traditional open surgery in treating abdominal incisional hernia for overweighted patients

Objective To explore the clinical outcome of laparoscopic and traditional open abdominal incisional hernia repair for overweighted patients.Methods From April 2007 to October 2015,forty-five overweighted patients with abdominal incision hernia undergoing surgical treatment were analyzed retrospectively,including 24 cases in laparoscopic group and 21 cases in open group.Statistical analysis were performed by using SPSS19.0 software.The measurement data such as operation time,hospital stay,blood loss,postoperative pain scores were expressed as ((x) ± s),and were examined by using t test.Count data such as complication rate and recurrence were examined by using x2 test,A P value ＜ 0.05 was considered as statistically significant difference.Results There were significant difference between two groups in terms of operation time of (76 ± 19.3) min vs (96 ±21.2) min,hospital stay (7.4 ±2.3) d vs (9.1 ± 1.2) d,intra-operative blood loss of (23 ±9.5) ml vs (185 ±32.4) ml,postoperative pain scores of (3.0 ± 0.8) vs (6.3 ± 0.9),(t =3.291,t =3.162,t =22.892,t =12.073 respectively,P ＜ 0.05).There was no significant difference in postoperative recurrence rate (x2 =1.416,P ＞ 0.05).Conclusion Laparoscopic incisional hernia repair has advantages of mini-invasive,rapid recovery,less complications,which is more suitable for overweighted patients with abdominal incisional hernia.