腹股沟疝网塞修补术与前入路腹膜前修补术前瞻性对照研究(附67例报告)

目的比较两种开放式无张力疝修补术的疗效。方法采用前瞻性随机对照方法,将67例69侧腹股沟疝分为两组:网塞修补组(34例)采用网塞行Rutkow术式,前入路腹膜前修补组(33例)采用15 cm×15 cm预裁剪聚丙烯平片行前入路腹膜前无张力疝修补术。结果均获随访,网塞修补组平均随访7.9个月,前入路腹膜前修补组随访8.1个月。两组平均手术时间、平均住院时间、恢复日常生活时间、切口并发症及阴囊积液发生率比较无显著性差异(P>0.05)。前入路腹膜前修补组平均费用明显少于网塞修补组,术后复发率、腹股沟区疼痛不适、异物感发生率也明显降低(P<0.05)。结论采用预裁剪补片行前入路腹膜前无张力腹股沟疝修补,可明显减少手术费用,降低术后疼痛不适、异物感的发生率,改善疗效,操作简便,安全经济,具有推广价值。

Tyco Mesh Plug and Preperitoneal Anterior Approach in Tension-free Repair for Inguinal Hernia: A Prospective Randomized Controlled Study

Objective To evaluate the therapeutic effect of the two different open tension-free herniorrhaphies Tyco mesh plug and preperitoneal anterior approach. Methods In a prospective randomized controlled study, 67 cases with 69 hernias （2 cases with bilateral hernias） were allocated randomly to either the Tyco mesh plug group （34 cases） or the preperitoneal anterior approach group （33 cases）. The former was received Rutkow hernia repair using Tyco mesh plug, the later was received preperitoneal tension-free hernia repair via open anterior approach with the polypropylene mesh. Results No significant differences were found between the two groups in the operation time, hospital stay, time for returning to work, incision complications or the rate of scrotal hydrocele（ P 〉0.05 ）. But the mean cost of treatment in preperitoneal anterior approach group was significantly less than that in Tyco mesh plug group （P 〈 0. 05 ）. However, in the aspects of recurrence rate, postoperative pain in the groin,and foreign body sensation, the outcome of preperitoneal anterior approach group was also significantly lower than that in the Tyco mesh plug group. Conclusions The preperitoneal anterior approach in repairing of inguinal hernia offers advantages of reducing the operative expense （ by using only single sheet mesh）, relieving the postoperative groin pain and foreign body sensation. It has characteristics of simple, security and inexpensive, and deserving to be popularized.