腹腔镜完全腹膜外疝修补术与腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的疗效

目的比较腹腔镜完全腹膜外疝修补术（TEP）与腹腔镜经腹腹膜前疝修补术（TAPP）在腹股沟疝中的应用效果。 方法回顾性分析2015年2月至2018年1月，新津县人民医院收治的80例腹股沟疝患者的临床资料，根据手术方式不同将其分为试验组及对照组，每组40例。试验组行TEP，对照组行TAPP，2组均行为期1年的随访。比较2组手术临床指标、术后疼痛情况，并统计2组术后并发症发生率。 结果试验组手术时间及铺片耗时分别为（60.27±4.23）min及（25.31± 4.86）min显著短于对照组（73.18±5.62）min及（28.73±5.12）min，差异有统计学意义（t=11.608、3.064，P<0.001、P=0.003）；试验组住院时间及胃肠功能恢复时间分别为（3.38±0.78）d及（15.08±0.91）min与对照组（3.14±0.71）d及（14.79±0.83）min比较，差异无统计学意义（t=1.439、1.489，P=0.154、0.140）。自术前至术后5个月试验组及对照组VAS评分均呈下降趋势，差异有统计学意义（F=252.345、181.841，P均<0.001），且术后2及5个月各时间点VAS评分试验组显著低于对照组（t=4.135、4.711，P均<0.001），术前及术后1 d时间点试验组VAS评分与对照组比较，差异均无统计学意义（t=1.645、1.444，P=0.869、0.153）。试验组并发症发生情况2（5%）与对照组8（20%）比较，差异无统计学意义（χ²=2.857，P=0.091）。 结论腹腔镜全腹膜外自固定补片植入术较经腹股沟腹膜前补片植入术可有效缩短手术时间及铺片时间，且术后疼痛较轻、并发症发生率较低。

Comparison of application effect of laparoscopic total extraperitoneal repair and transabdominal preperitoneal repair in inguinal hernia

ObjectiveTo compare the application effect of laparoscopic total extraperitoneal (TEP) repair and transabdominal preperitoneal (TAPP) repair in the inguinal hernia. MethodsThe clinical data of 80 patients with inguinal hernia admitted to Xinjin People's hospital from February 2015 to January 2018 were retrospectively analyzed, and they were divided into the study group and the control group according to the different operation method, with 40 cases in each group. The study group was treated with TEP repair, and the control group underwent TAPP repair. Both groups were followed up for 1 year. The clinical indicators and postoperative pain of the two groups were compared, and the postoperative complications occurrence rate was noted. ResultsThe operation time and mesh implantation time in the study group were significantly shorter than those in the control group (60.27±4.23) minutes vs (73.18±5.62) minutes, (25.31±4.86) minutes vs (28.73±5.12) minutes, t=11.608, 3.064, P<0.001, P=0.003]. There were no significant differences in the hospitalization time and the gastrointestinal function recovery time between the two groups (3.38±0.78) days vs (3.14±0.71) days, (15.08±0.91) minutes vs (14.79±0.83) minutes, t=1.439、1.489, P=0.154、0.140]. The VAS scores of the 2 groups showed a downward trend from before operation to 5 months after operation (F=252.345, 181.841, all P<0.001). At each time point of 2 months and 5 months after the surgery, the study group showed lower VAS score than the control group (t=4.135, 4.711, all P<0.001). There was no significant difference in the incidence of complications between the study group and the control group (5% vs 20%, χ²=2.857, P=0.091). ConclusionTEP repair can effectively shorten the operative time and mesh implantation time compared with TAPP repair, with less postoperative pain and low incidence of complications.