腹腔镜经腹腹膜前疝修补术治疗腹股沟斜疝的效果

目的探讨腹腔镜经腹腹膜前疝修补术（TAPP）治疗腹股沟斜疝患者的临床效果。 方法回顾性分析2020年5月至2021年12月芜湖市第五人民医院普外科接诊的腹股沟斜疝患者60例。依手术方法分为2组，对照组行Lichtenstein疝修补术（n=30），观察组行腹腔镜TAPP（n=30）。对比2组患者手术相关指标，术后不同时间疼痛（视觉模拟评分）、术后并发症、术前以及术后3个月的生活质量（SF-36量表）。 结果2组患者总医疗费用差异无统计学意义（P>0.05）。观察组失血量、术后肠鸣音恢复时间、肛门排气时间、恢复自主活动时间、总住院时间低于对照组，观察组手术耗时、治疗满意度评分高于对照组（P<0.05）。观察组术后6 h、12 h、24 h、48 h疼痛评分均低于对照组（P<0.05），术后1个月2组差异无统计学意义（P>0.05）。观察组术后并发症发生率低于对照组（P<0.05）。2组术后3个月SF-36评分较术前均明显增加（P<0.05），2组间差异无统计学意义（P>0.05）。 结论腹腔镜TAPP治疗腹股沟斜疝较Lichtenstein手术对组织创伤程度低，术后恢复速度快，术后短期内疼痛程度、并发症发生率低，术后早期恢复效果好，近期恢复效果与Lichtenstein术类似。

Clinical effect of laparoscopic trans-abdominal preperitoneal hernia repair for indirect inguinal hernia

ObjectiveTo explore the clinical effect of laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) in patients with indirect inguinal hernia. Methods60 patients with indirect inguinal hernia admitted in Department of General Surgery of Wuhu Fifth People's Hospital from May 2020 to December 2021 were retrospectively analyzed. All patients were divided into 2 groups according to different surgical methods. The control group (n=30) used Lichtenstein hernia repair, and the observation group (n=30) used TAPP repair. The operation related indexes, pain severity [visual analogue scale (VAS)] at different time after operation, postoperative complications, quality of life (SF-36 scale) before and three month after operation were compared between the two groups. ResultsThere was no significant difference in the total medical expenses between the two groups (P>0.05). The blood loss, recovery time of postoperative bowel sounds, anal exhaust time, recovery time of autonomous activities and total hospitalization time in the observation group were lower than those in the control group, and the operation time and treatment satisfaction score in the observation group were higher than those in the control group (P<0.05). The pain scores of the observation group at 6h, 12h, 24h and 48h after operation were lower than those of the control group (P<0.05). There was no statistical difference in the pain scores of the two groups at one month after operation (P>0.05). The postoperative complication rate in the observation group was lower than that in the control group (P<0.05). Three months after operation, SF-36 scores of patients in both groups increased significantly (P<0.05), but there was no significant difference between the two groups (P>0.05). ConclusionPatients with indirect inguinal hernia treated by laparoscopic TAPP repair has low degree of tissue trauma, fast postoperative recovery, low postoperative pain in the short term, low risk of complications, and better postoperative recovery effect compared to Lichtenstein repair. In terms of recent recovery effect, TAPP repair is similar to Lichtenstein repair.