腹腔镜经腹腹膜前疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的临床疗效

目的探讨腹腔镜经腹腹膜前疝修补术（laparoscopic trans-abdominal preperitoneal hernia repair，TAPP）与开放式无张力疝修补术治疗成人腹股沟疝的临床疗效。 方法回顾性分析2017年10月至2018年12月，安徽医科大学附属六安医院198例腹股沟疝患者临床资料，根据手术方法不同分为腔镜组（90例）和开放组（108例）。腔镜组行TAPP术式，开放组行开放式无张力疝修补术。比较2组手术相关临床参数、术后不同时间疼痛程度及术后并发症发生情况。 结果与开放组比较，腔镜组术后肠鸣音恢复时间、肛门排气时间、自主活动时间、术后痛感持续时间及住院时间明显缩短，差异有统计学意义（P<0.05）；2组手术时间及住院费用比较，差异无统计学意义（P>0.05）；术后12 h至7 d，2组患者视觉模拟评分（visual analogue scale，VAS）均呈逐渐降低趋势，且腔镜组均明显低于开放组，差异均有统计学意义（P<0.05）。腔镜组并发症发生率明显低于开放组，差异有统计学意义（P<0.05）。 结论相较于开放式无张力疝修补术，TAPP可明显缩短腹股沟疝患者术后疼痛持续时间，减少术后并发症，有利于患者术后恢复。

Comparative analysis of the clinical efficacy of laparoscopic transabdominal preperitoneal hernioplasty and open tension-free hernioplasty for the treatment of adult inguinal hernia

ObjectiveTo analyze the clinical efficacy of laparoscopic transabdominal preperitoneal hernioplasty (TAPP) and open tension-free hernioplasty for the treatment of adult inguinal hernia. MethodsThe clinical data of 198 patients with inguinal hernia admitted to Lu'an Hospital affiliated to Anhui Medical University from October 2017 to December 2018 were retrospectively analyzed, they were divided into the laparoscopic group (n=90) and the open group (n=108) according to different surgical methods. The laparoscopic group underwent TAPP, and the open group underwent open tension-free hernioplasty. The clinical parameters, the pain degree at different time after operation and the postoperative complications of the 2 groups were compared. ResultsCompared with the open group, the postoperative bowel sound recovery time, anal exhaust time, spontaneous activity time, the duration time of pain postoperative and hospitalization time significantly shortened in the laparoscopic group (P<0.05); the operation time and hospitalization costs had no significant difference in 2 groups (P>0.05). The VAS scores of the 2 groups gradually decreased from 12 hours to 7 days after operation, and the laparoscopic group was significantly lower than the open group (P<0.05). The incidence of complications in the laparoscopic group was significantly lower than that in the open group (P<0.05). ConclusionCompared with open tension-free hernioplasty, TAPP can significantly shorten postoperative duration time of pain in patients with inguinal hernia, and has fewer postoperative complications, which is benefit to postoperative recovery.