腹腔镜下完全腹膜外与经腹腹膜前腹股沟疝修补术的临床疗效

目的对比腹腔镜下完全腹膜外与经腹腹膜前腹股沟疝修补术的临床疗效。 方法分层抽取深圳市光明新区人民医院普外科2014年1月至2016年1月，收治的腹腔镜下腹股沟疝修补术患者68例，采用随机数字表法将其分为观察组及对照组，每组34例患者。观察组采用完全腹膜外修补法（laparoscopic totally extraperitoneal，TEP），对照组采用经腹腹膜前修补法（laparoscopic transabdominal preperitoneal hernia repair，TAPP），术后对2组患者随访6～18个月，对比2组术中情况、住院时间，同时比较2组术后疼痛、并发症发生情况及复发情况。 结果观察组患者术后首次肛门排气时间、住院时间、术后疼痛时间均显著低于对照组（t=7.83、6.16、11.11，P均<0.05）；观察2组并发症发生率及腹股沟疝复发率均无明显差异（χ²=0.77、0.57，P=0.38、0.45）。 结论TEP较TAPP能进一步缩短术后疼痛时间及住院时间，但TEP对手术医师操作能力有较高要求，有待进一步培训推广。

Clinical comparison of laparoscopic totally extraperitoneal and tranabdominal preperitoneal inguinal hernia repair

ObjectiveTo investigate the clinical effect of laparoscopic totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) inguinal hernia repair. Methods68 patients underwent laparoscopic inguinal hernia repair in Shenzhen Guangming New District People's Hospital were enrolled from January 2014 to January 2016. The patients were randomly divided into observation group and control group, and 34 cases in each group. The patients in the observation group were treated with TEP repair, and the patients in the control group was treated with TAPP repair. The patients were followed up for 6 to 18 months. The hospitalization time, the postoperative pain, the complications and recurrence between the two groups were compared. ResultsThe duration of anal exhaust time, hospital stay and postoperative pain were significantly lower in the observation group than in the control group (t=7.83, 6.16, 11.11; P<0.05). There was no significant difference between the incidence of complications and the recurrence rate of inguinal hernia (χ²=0.77, 0.57; P=0.38, 0.45). ConclusionTEP can further shorten the postoperative pain time and hospitalization time compared with TAPP. However, TEP has a high requirement for surgeons, and it needs to be further promoted.