传统、疝环充填式及经前入路腹膜前间隙腹股沟疝修补术的对比研究

目的研究比较传统、疝环充填式及腹膜前间隙疝修补术的临床效果。方法1997年至2005年采用传统方法修补腹股沟疝325例,2001年后采用疝环充填式疝修补术128例及2007年后腹膜前间隙疝修补术50例。结果传统疝修补术组平均手术时间为(65±25)min,疝环充填式组为(45±20)min,腹膜前间隙组为(40±20)min。随访1～4年,复发率分别为5.02%,1.92%,0%。结论同传统腹股沟疝修补术比较,疝环充填式无张力修补术和腹膜前间隙疝修补术具有手术时间短、痛苦小、恢复快、复发率低的特点,腹膜前间隙疝修补术更符合工程力学原理,术后疼痛更轻、恢复更快,具有免缝合,微创手术的特点。腹膜前间隙疝修补术是一种具有良好发展潜力的无张力疝修补术。

Comparison of conventional and mesh plug tension-free and preperitoneal space inguinal herniorrhaphy

Objective To compare the results of original herniorrhaphy, plug tension - free herniorrhaphy and preperitoneal herniorrhaphy. Methods The clinical data including 3 groups, 325 cases were treated by the original herniorrhaphy lasted from 1997 to 2005,128 cases were treated by the plug tension - free herniorrhaphy after 2001 and 50 cases were treated by the preperitoneal herniorrhaphy after 2007. Resuits The mean operative time were （65 ±25 ）min for the original group, （45 ± 20）min for the plug tension - free group and （40 ± 20） min for the preperitoneal group. The follow - up lasted 4 years , the recurrence rate were 5.02% for the original group, 1.92% for the plug tension - free group and 0% for the preperitoneal group. Conclusions To compare with the original, the plug tension - free and preperitoneal herniorrhaphy were more rapid, less painful, lower recurrence rate. Compared with the plug tension -free herniorrhaphy, the preperitoneal herniorrhaphy was more consistent with the engineering mechanics principle, it was the minimally invasive and sutureless herniorrhaphy, it was more similar to the laparoscopic hernia repair. As a kind of tension - free hernioplasty, the preperitoneal herniorrhaphy should be performed widely.