腹腔镜经腹膜前疝修补术与传统疝修补术的回顾性分析

目的探讨腹腔镜经腹膜前疝修补术(transabdominal preperitoneal,TAPP)与传统无张力疝修补术治疗成人腹股沟疝的临床疗效。方法回顾性分析合肥市第二人民医院普外科2013年1月至2017年12月收治的350例腹股沟疝病人的临床资料,其中传统无张力疝修补术组(对照组)200例,TAPP组150例。结果两组病人均顺利完成手术,TAPP组无中转开腹。对照组在手术时间及住院费用明显低于TAPP组,差异均有统计学意义(均P<0.05)。两组间住院时间及术后下床活动时间比较差异无统计学意义(P>0.05)。两组间术后第1天疼痛分数比较差异有统计学意义(P<0.05)。对照组与TAPP组总的并发症发生率分别为38%和22%,差异有统计学意义(P<0.05)。两组间术后切口感染、腹股沟区疼痛及神经感觉异常的发生率差异有统计学意义(P<0.05)。两组间阴囊血肿、血清肿发生率及术后复发率差异无统计学意义(P>0.05)。结论 TAPP作为众多无张力疝修补术其中的一种方法,是另一种安全、有效的治疗成人腹股沟疝的手术方法。

Comparative study of laparoscopic transabdominal preperitoneal repair and open tension-free inguinal hernia repair for inguinal hernia

Objective To discuss the clinical curative effect of laparoscopic transabdominal preperitoneal repair and open tension-free inguinal hernia repair in adults. Methods The clinical data of 350 patients with inguinal hernia in Second People's Hospital of Hefei was retrospectively analyzed.150 patients in test group were applied with TAPP,and 200 patients in control group with open tension-free inguinal hernia repair. Results Both two groups successfully underwent completed the operation,and the TAPP group did not have a transit open surgery.Compared to the TAPP group,the open group showed significantly shorter operation time,lower hospital cost(P<0.05).There was no significantly difference in hospitalization time,postoperative activity time,incisional seroma,scrotal hematoma and hernia re-recurrence.There was significantly difference in total complication rate,wound infection,wound pain and pain score. Conclusion As a method of numerous tension-free hernia repair,TAPP was safe and effective surgical method for treating adult inguinal hernia.