完全腹膜外疝修补术与经腹腹膜前疝修补术的临床疗效对比

目的：探讨完全腹膜外疝修补术（TEP）与经腹腹膜前疝修补术（TAPP）的临床疗效。方法回顾性分析2010年1月至2013年5月，成都军区昆明总医院收治的腹股沟疝患者216例，均行TAPP或TEP。比较二组患者的手术后疼痛持续时间、并发症及复发情况、住院时间及住院费用。结果 TAPP和TEP组术后疼痛持续时间（｜Z｜＝0．563，P＝0．574）、术后住院时间（｜Z｜＝0．497，P＝0．619）的比较差异均无统计学意义，术后TAPP组复发（对侧复发）1例，TEP组无复发，差异无统计学意义（χ2＝0．718，P＝0．397）；TEP组并发皮下气肿1例，占全部TEP患者总数的1．11％，TAPP组无气肿发生；TAPP组住院费用（8908±611元）低于 TEP组（9123±580元），差异有统计学意义（F＝24．266，P＝0．003）。结论 TAPP与TEP在临床疗效上无差别，但在住院费用上，TAPP相较比TEP稍少，可依据患者经济水平、意愿以及术者水平等综合选择不同的手术方式。

Comparison of clinical efficacy between totally extraperitoneal and transabdominal preperitoneal laparoscopic inguinal hernia repair

Objective To investigate the clinical effect of totally extraperitoneal （TEP ） and transabdominal preperitoneal laparoscopic inguinal hernia repair （TAPP ）.Methods 21 6 patients with inguinal hernia who underwent either TAPP or TEP in General Hospital of Chengdu Military Region Kunming from January 201 0 to May 201 3 were retrospectively analyzed.Both patient-groups were compared with duration of postoperative pain,cases of complications and recurrence,postoperative hospitalization stay and costs.Results There was no statistically significant difference between TAPP and TEP in duration of postoperative pain （｜Z｜ =0.563,P=0.574）,and in postoperative hospitalization stay （｜Z｜ =0.497,P=0.61 9）.One case each of subcutaneous emphysema and recurrence （in contralateral）were occurred in TEP group,none was in TAPP group（χ2 =0.71 8,P=0.397）.In terms of hospitalization costs,TAPP cost less than TEP costs,group TAPP spent an average of less than group TEP（F=24.266,P=0.003）.Conclusions It seems no difference in clinical curative effect between TAPP and TEP,but TAPP costs less than TEP. That indicated patients who want to take an ideal operation about laparoscopic inguinal herniorrhaphy can make a comprehensive decision on the basis of their economic level and their own intention,as well as experience of surgeon.