完全腹膜外疝修补术与Lichtenstein术治疗腹股沟疝的疗效比较

目的探讨腹腔镜完全腹膜外疝修补术（TEP）与Lichtenstein术治疗腹股沟疝的临床疗效及并发症影响。 方法回顾性分析2018年6月1日至2021年6月1日中国人民解放军联勤保障部队第967医院普外科收治的126例腹股沟疝患者临床资料。74例患者接受TEP手术，为TEP组；52例接受Lichtenstein术，为开放组；对比2组手术相关指标、术后1周并发症（阴囊水肿、切口感染、尿潴留、暂时性神经感觉异常）发生率及术后不同时间腹股沟区视觉模拟评分（VAS）。 结果TEP组手术时间、住院费用明显高于开放组，术中出血量、住院时间，术后1周并发症（阴囊水肿、切口感染、尿潴留、暂时性神经感觉异常）发生率明显低于开放组，差异有统计学意义（P均<0.05）。术后24 h及1、3个月腹股沟区VAS评分明显低于开放组，差异有统计学意义（P均<0.05）；但术后6个月VAS评分与开放组相比差异无统计学意义（P>0.05）。 结论TEP手术具有创伤小、疼痛轻、恢复快、住院时间短、并发症发生率低的特点，治疗效果明显优于Lichtenstein术，但其费用高、手术用时长，临床应用中应根据患者自身情况及手术医师所掌握的手术技能选择合适的手术方式。

Comparison of total extraperitoneal herniorrhaphy and Lichtenstein surgery in the treatment of inguinal hernia

ObjectiveTo study the clinical effects and complications of laparoscopic total extraperitoneal hernia repair (TEP) and Lichtenstein hernia repair for inguinal hernias. MethodsRetrospective analysis of the clinical data of 126 patients with inguinal hernias admitted to the General Surgery Department of the 967th Hospital of the Joint Logistic Support Force of the PLA from June 1, 2018 to June 1, 2021. 74 patients received TEP operation, in the TEP Operation Group; 52 patients received Lichtenstein operation, in the Open Operation Group; The incidence of postoperative complications (scrotal edema, incision infection, urinary retention, temporary neurosensory disturbance), and visual analogue scale (VAS) pain in the inguinal area were compared between the two groups, to evaluate and analyze the advantages of laparoscopic total extraperitoneal hernia repair. ResultsCompared with the open group, the operation time and hospital expenses of the TEP group were significantly higher (P<0.05); intraoperative blood loss, hospital stay, and postoperative complications (scrotal edema, incision infection, the incidence rates of urinary retention, temporary neurosensory abnormalities) in the TEP group were significantly lower; the VAS scores of the inguinal region in the TEP group were significantly lower at 24 hours, 1 month and 3 months after operation. There were all statistical significance (P<0.05). There was no significant difference in the inguinal region VAS score between the two groups at 6 months after operation (P>0.05). ConclusionTEP has the characteristics of less trauma, less pain, faster recovery, shorter hospital stay, and lower complication rate. The therapeutic effect of TEP is obviously better than the Lichtenstein procedure, but the operation time and hospital expenses of the TEP group were significantly higher. In clinical application, the appropriate operation method should be selected according to the patient's own situation and the surgical skills mastered by the surgeon.