腹腔镜下完全腹膜外疝修补术治疗老年单侧腹股沟疝的随机对照研究

目的研究腹腔镜下完全腹膜外疝修补术治疗老年单侧腹股沟疝的临床效果。方法研究对象为北京大学深圳医院2015年10月到2017年7月单侧腹股沟疝患者120例,根据手术治疗方法不同随机分为对照组与观察组各60例。对照组采用局麻下开放式腹股沟疝无张力修补术(OTFHULA);观察组采用腹腔镜下完全腹膜外腹股沟疝无张力修补术(TEP)。比较不同手术方式患者手术时间、术中出血量、总住院费用、术后恢复正常活动时间、术后第1天疼痛数字评分(NRS)、术后近期并发症发生率、术后远期并发症发生率。结果手术时间、术中出血量、总住院费用观察组大于对照组(P均<0.001);术后恢复正常活动时间、术后第1天疼痛数字评分观察组小于对照组(P<0.05)。术后近期并发症发生率、术后远期并发症发生率与对照组差异无统计学意义。结论对于老年单侧腹股沟疝患者,OPFHULA组和TEP组治疗均有各自优缺点,临床可根据患者的实际情况及术者对术式的熟练程度合理选择手术方式。

A randomized controlled study of totally extraperitoneal laparoscopic herniorrhaphy on uinlateral inguinal hernia in elderly patients

Objective To observe the clinical effect of extraperitoneal laparoscopic herniorrhaphy on unilateral inguinal hernia in elderly patients. Methods 120 cases of unilateral inguinal hernia in Peking University Shenzhen Hospital from October 2015 to July 2017 were randomized into the control group and the observation group(60 cases each). The control group was treated with tension free inguinal hernia repair under local anesthesia(open tension-free hernia repair under local anesthesia,OTFHULA), and the observation group was treated with extraperitoneal laparoscopic herniorrhaphy on inguinal hernia repair(totally extraperitoneal prosthesis,TEP). The operation time,intraoperative bleeding volume, total hospitalization cost,postoperative recovery time,the first day postoperative pain score(numeric rating scale,NRS),the incidence of postoperative complications and postoperatively long term complications were compared in the patients with different surgical methods. Results The observation group of the operation time,intraoperative bleeding volume and the total hospitalization cost in the observation group were larger than those in the control group,and the observation group after the operation,postoperative NRS was less than the control group(P<0.05). There was no significant difference in the first day the incidence of postoperative complications and postoperatively long term complications in the observa-tion group. Conclusion For the elderly patients with unilateral inguinal hernia,group OPFHULA and group TEP have their own advantages and disadvantages,which can be rationally selected according to the actual situation of the patients and the skilled degree of the operation.