腹腔镜经腹腹膜前疝修补术与Lichtenstein疝修补术治疗腹股沟疝患者的临床疗效

目的比较腹腔镜经腹腹膜前疝修补术（laparoscopic trans-abdominal preperitoneal hernia repair，TAPP）与Lichtenstein疝修补术治疗腹股沟疝患者的临床疗效。 方法回顾性分析2016年3月至2018年3月，海南省人民医院收治的腹股沟疝患者180例，根据术式不同将其分为试验组及对照组，每组患者90例。试验组行TAPP术式，对照组行Lichtenstein术式。比较2组手术临床指标及术后疼痛情况，观察2组术后并发症及复发情况。 结果试验组手术时间、住院时间及术后首次下床活动时间较对照组显著缩短，术中出血量及住院总费用较对照组显著减少，差异有统计学意义（P<0.05）。自术前至术后6个月2组视觉模拟评分（visual analogue score，VAS）均呈下降趋势，且术后各个时间点试验组VAS评分均显著低于对照组，差异均有统计学意义（P<0.05）。2组并发症发生率比较，差异无统计学意义（8.89% vs 12.22%，P>0.05）；2组复发率比较，差异无统计学意义（0.00% vs 2.22%，P>0.05）。 结论TAPP与Lichtenstein疝修补术各有优缺点，前者手术时间与住院时间短、术后疼痛较轻，但住院费用较高；后者术后首次下床活动时间较长、住院费用较低，但术后疼痛时间较长。

Clinical study of different herniorrhaphy for inguinal hernia

ObjectiveTo compare the clinical efficacy of laparoscopic transabdominal preperitoneal (TAPP) hernia repair and Lichtenstein repair in the treatment of inguinal hernia. Methods180 patients with inguinal hernia admitted to Tunchang County People's hospital from March 2016 to March 2018 were selected, and divided into the experiment group and the control group according to the different operation method, 90 cases in each group. The experiment group underwent TAPP repair, and the control group underwent Lichtenstein repair. The clinical indicators and postoperative pain of the two groups were compared, and the postoperative complications and recurrence of the two groups were observed. ResultsThe operation time, hospitalization time and postoperative ambulation time in the experiment group were significantly shorter than those in the control group. The intraoperative blood loss and hospitalization costs in experiment group were lower than those in the control group (P<0.05). The VAS scores of the 2 groups showed a downward trend from preoperative to 6 months after operation (P<0.05). The VAS scores of the experiment group were significantly lower than those of the control group at each time points after operative (P<0.05). There was no statistical difference between the two groups in the incidence of complications (8.89% vs 12.22%) (P>0.05), and there was no statistical difference in the recurrence rate (0 vs 2.22%) (P>0.05). ConclusionBoth TAPP and Lichtenstein hernia repair have advantages and disadvantages respectively. The former has a shorter operation time and hospitalization time, less postoperative pain, but higher hospital expenses; the latter has a longer ambulation time and lower hospitalization costs, but a longer postoperative pain time.