腹腔镜免钉合经腹部分腹膜外网片植入术与经腹腹膜前修补术的疗效比较

目的:对比分析腹腔镜免钉合经腹部分腹膜外网片植入术(transabdominal partial extraperitoneal,TAPE)与腹腔镜经腹腹膜前修补术(transabdominal preperitoneal,TAPP)的并发症及临床疗效。方法:回顾分析2007年7月至2010年6月为38例患者行免钉合TAPE(TAPE组)及为65例患者行TAPP(TAPP组)的临床资料,对比两组手术时间、住院时间、住院费用、疼痛视觉模拟评分(visual analogue scales,VAS)及3年复发率。结果:两组患者手术时间差异有统计学意义(P<0.05);住院时间、住院费用、术后1周VAS评分差异无统计学意义(P>0.05);术后半年TAPE组及TAPP组VAS评分分别为(0.37±0.13)分及(1.62±0.44)分,差异有统计学意义(P<0.01);3年复发率分别为2.63%、3.08%,差异无统计学意义(P>0.05)。结论:免钉合TAPE及TAPP治疗腹股沟疝均是安全、有效的,免钉合TAPE在缩短手术时间及减少慢性疼痛方面具有一定优势。

Comparative analysis of laparoscopic transabdominal partial extraperitoneal technique without stapling and transabdominal preperitoneal technique in inguinal herniorrhaphy

Objective： To compare the complications and efficiency of laparoscopic transabdominal partial extraperitoneal （TAPE） technique without stapling with transabdominal preperitoneal （TAPP） technique in inguinal herniorrhaphy. Methods ：The av- erage operation time, hospital stay time, hospitalization expenses, visual analogue scales （VAS） of chronic pain and 3 year recurrent rates were analyzed retrospectively between 38 cases of inguinal hernia which underwent laparoscopic TAPE without stapling and 65 ca- ses of inguinal hernia which underwent TAPP during Jnl. 2007 and Jun. 2010 in Shanghai East Hospital. Results：As to TAPE group and TAPP group, the average operation time was （51.20 -＋ 11.58 ） min and （67.42 _＋ 19.66 ） min respectively （ P 〈 O. 05 ）, the average hospital stay was （3.13 ~ O. 11 ） d and （3.28 ~ O. 30） d respectively （ P 〉 O. 05 ）, the hospitalization expenses was （ 14 350 ＋ 936 ） RMB and （ 14 193 ~ 1 722） RMB respectively （ P 〉 0.05 ）, the average VAS of pain one week after operation was （ 2.82 ~ 0.54） and （3.47 ~0.61 ） respectively （P 〉0.05） ,the average VAS of pain 6 months after operation was （0.37 ~0.13） and （ 1.62 ＋0.44） re- spectively （ P 〈 0.01 ）, and the 3 year recurrent rate was 2.63% and 3.08% respectively （ P 〉 0.05 ）. Conclusions： Both TAPE with- out stapling and TAPP are safe and effective for inguinal hernia. TAPE without stapling may have some advantages in operation time and chronic pain comparing with TAPP.