腹腔镜经腹腹膜前疝修补术在成人腹股沟嵌顿疝中的应用

目的研究腹腔镜经腹腹膜前疝修补术（laparoscopic trans-abdominal preperitoneal hernia repair，TAPP）在成人腹股沟嵌顿疝治疗中的应用价值。 方法回顾性分析2015年1月至20l8年5月，河源市中医院收治的64例成人腹股沟嵌顿疝手术患者的临床资料，根据手术方式分为TAPP组和开放无张力疝修补术组（开放组），其中TAPP组35例，开放组29例。比较2组的手术时间、术中出血量、术后下床时间、术后住院时间、术后并发症等情况。 结果TAPP组和开放组的术后下床时间（3.7±2.3）h vs（7.6±3.7）h]、术后住院时间（3.2±2.1）d vs（6.4±1.6）d]、术后并发症发生率（4/35 vs 12/29）比较，差异均有统计学意义（P<0.05）；手术时间（72.1±26.9）min vs（64.2±23.6）min]、术中出血量（15.4±7.3）mL vs（11.7±6.1）mL]、术后各项并发症比较，差异均无统计学意义（P>0.05）。 结论TAPP治疗成人腹股沟嵌顿疝具有创伤小、恢复快的优点，是一种安全有效的手术方式。

Application of TAPP in treatment of adult incarcerated inguinal hernia

ObjectiveTo study the application value of transabdominal preperitoneal prosthesis (TAPP) in the treatment of adult incarcerated inguinal hernia. MethodsThe clinical data of 64 patients of adult incarcerated inguinal hernia from January 2015 to May 2018 were retrospectively analyzed. According to the surgical approach, patients were divided into TAPP group (35 cases) and open group (open tension free hernia repair, 29 cases). The operative time, intraoperative bleeding volume, time to ambulation, postoperative hospitalization time and postoperative complications, were compared between the two groups. ResultsThere were statistical significance differences in time to ambulation (3.7±2.3 hours vs 7.6±3.7 hours), postoperative hospitalization time (3.2±2.1 days vs 6.4±1.6 days) and overall incidence of complications (4/35 vs 12/29) between TAPP group and open group (P<0.05). There were no statistical significance differences in operation time (72.1±26.9 minutes vs 64.2±23.6 minutes), intraoperative blood loss (15.4±7.3 mL vs 11.7±6.1 mL), and postoperative complications between the two groups (P>0.05). ConclusionTAPP is a safe and effective operation for adult incarcerated inguinal hernia with the advantages of less trauma and rapid recovery.