腹腔镜与开放式手术治疗成人脐疝的临床比较

目的：比较腹腔镜与开放式手术治疗成人脐疝的临床疗效。方法回顾性分析2008年3月至2013年1月，河南省南阳医专第一附属医院收治成人脐疝77例患者的临床资料。行腹腔镜手术35例，行开放式手术42例。比较二种手术方式的手术时间、住院时间、手术费用、术后疼痛时间、术后并发症以及术后复发率等临床指标。结果腹腔镜组患者的手术时间、住院时间和术后疼痛时间均短于开放组，差异有统计学意义（t＝3．46、2．85、3．06，P＝0．01、0．02、0．01）；手术费用明显高于开放组，差异有统计学意义（t＝27．81，P＝0．00）。腹腔镜组的并发症发生率与开放组相比明显减少（χ2＝5．704，P＝0．017），二组患者在随访期间内腹腔镜组无复发病例，而开放组有2例复发，差异无统计学意义（χ2＝1．632，P＝0．201）。结论对于成人脐疝患者，应用腹腔镜手术治疗疗效显著，外科创伤相对较小，术后疼痛轻，不影响美观，有望成为成人脐疝修补的首选方法。

Comparison of laparoscopic and open operation in treatment of adult umbilical hernia

Objective To compare the clinical effect of laparoscopic and open operation in treatment of adult umbilical hernia.Methods From March 2008 to January 201 3,a total of 77 patients with adult umbilical hernia were enrolled and retrospectively analyzed from The First Affiliated Hospital of Nanyang Medical College.Of them,35 cases were applied with laparoscopic operation and 42 patients with open operation.The operation time,mode,cost,postoperative pain,complications,recurrence rate and other clinical parameters were assessed.Results The operation time,hospitalization time and time for postoperative pain in the laparoscopic group were shorter than those in the open group with statistically significant difference （t=3.36,2.85,3.06,P=0.01 ,0.02,0.01 ）.The operation cost was more expensive compared to the open group （t=27.81 ,P=0.00）.The complication rate of both groups decreased （χ2 =5.704,P=0.017））.No recurrence was observed in the laparoscopic group and there were 2 cases of recurrences in the open group without any significant difference（χ2 =1 .632,P=0.201 ）.Conclusions The laparoscopic operation has superior effect in the patients with adult umbilical hernia with small operation wound,and less postoperative pain.