腹腔镜与开放无张力疝修补术在复发性腹股沟疝治疗中的对比分析

目的评价腹腔镜疝修补术与开放性无张力疝修补术治疗复发性腹股沟疝的短期和长期疗效。方法回顾性分析2009年10月至2011年7月四川省人民医院收治的复发性腹股沟疝73例（77例次）的临床资料。其中试验组36例（39例次），行腹腔镜腹股沟疝修补术（TAPP）；对照组37例（38例次），行开放式无张力修补术（OMR）。结果二组患者在手术时间、术后住院时间、术前并发症、术后尿潴留、血清肿上差异元统计学意义（t=1．735、-1．085，X2=0．377、0．097、4．118，P=0．324、0．083、0．962、0．445、0．070）。术后1周随访在切口感染、睾丸疼痛、血清肿、血肿方面差异有统计学意义（X2=3．044、2．000、0．986、3．986，P=0．004、0．022、0．005、0．009）。在术后3个月时，二组患者在局部炎症和术区慢性疼痛方面差异无统计学意义（X2=0．874、0．722，P=0．244、0．315）。术后患者均得到随访，随访3～42个月，中位时间26个月，二组患者各复发1例。结论TAPP在治疗复发性腹股沟疝时，短期效果上，术后疼痛更轻，并发症更少；长期效果上，与OMR同样安全有效，在术后疼痛和复发率上无区别。

Comparison of laparoscopic hernia repair and open tension-free hernia repair in treatment of recurrent inguinal hernia

Objective To assess the short-term and long-term curative effects of laparoscopic hernia repair and open tension-free hernia repair in treatment of recurrent inguinal hernia. Methods A total of 73 cases with recurrent inguinal hernia in Sichun Provincial People＇s Hospital from October 2009 to July 2011 were retrospectively analyzed. Thirty-six cases were included in the test group and applied with laparoscopic inguinal hernia repair （TAPP）. The control group included 37 cases with open tension-free repair （OMR）. Results No significant difference in operation time, postoperative hospitalization time, preoperative complications, postoperative urinary retention, or seroma was observed （t = 1. 735, - 1. 085, X2 = 0. 377,0. 097,4. 118, P = 0. 324,0. 083,0. 962,0. 445,0. 070）. One week after operation, there was statistically significant difference in incision infection, testicular pain, seroma, hematoncus between two groups （X2 = 3. 044,2. 000,0. 986,3. 986, P = 0. 004,0. 022,0. 005,0. 009 ）. Three months after operation, there was no statistically significant difference in local inflammation and chronic pain between two groups （X2 =0. 874,0. 722,P =0. 244,0. 315）. The patients were followed up for 3 to 42 months after operation with a median of 26 months. Only one case of relapse was found. Conclusions Postoperative pain was less in short-term treatment of recurrent inguinal hernia with fewer complications, white there was no difference in postoperative pain and recurrence rate as compared with tension-free repair.