经腹腔镜与开放式疝修补手术的随机对照研究

目的:比较经腹腔镜与开放式4种术式修补腹股沟疝的效果.方法:将连续100例Nyhus Ⅰ～Ⅲ型原发性腹股沟疝患者随机均分为4组,Ⅰ组行开放式腹膜前修补术,Ⅱ组行Lichtenstein无张力疝修补术,Ⅲ组行腹腔镜经腹腔腹膜前补片植入术(TAPP),Ⅳ组行腹腔镜全腹膜外补片修补术(TEP).结果:Ⅲ、Ⅳ组患者手术时间均长于Ⅰ、Ⅱ组(P<0.01),Ⅰ组手术时间长于Ⅱ组(P<0.05).Ⅰ、Ⅱ组患者术后6 h疼痛均强于Ⅳ组(P<0.01和P<0.05).Ⅲ、Ⅳ组中各1例中转开腹手术.经腹腔镜手术恢复工作时间显著快于Ⅰ、Ⅱ组(P<0.01).结论:TEP和TAPP治疗腹股沟疝的效果相似,较开放式修补术后疼痛少,恢复快.

A comparative study of treatment inguinal hernia with laparoscopic hernia repair and open hernia repair

Objective:To compare the effects of four different repairs on inguinal hernia.Methods:One hundred cases with primary inguinal hernia of NyhusⅠ–Ⅲ were randomly divided into four groups.Group Ⅰwere treated with open properitoneal repair,group Ⅱ were treated with Lichtenstein tension-free repair,group Ⅲ were treated with transabdominal properitoneal(TAPP) repair and group Ⅳ were treated with laparoscopic totally extraperitoneal(TEP) repair.Results:The operative time of group Ⅲ and Ⅳ were longer than that of group Ⅰ and Ⅱ(P<0.01).Compared with group Ⅱ,the operative time of groupⅠwas long(P<0.05).Postoperative pain of group Ⅰ and Ⅱwere stronger than that of group Ⅳ within 24 hours after operation(P<0.01 and P<0.05).One case in group Ⅲ and one in group Ⅳ conversed to open procedure.The activity time of cases treated with laparoscopic operation were significantly shorter than that of group Ⅰ and Ⅱ(P<0.01).Conclusions:The effects of TEP and TAPP are similar.Laparoscopic hernia repair is less postoperative pain and fast recovery.