腹腔镜与开放疝修补术治疗腹壁疝的疗效比较研究

目的:评价腹腔镜腹壁疝修补术(laparoscopic ventral hernia repair,LVHR)与开放修补术治疗腹壁疝的临床应用效果。方法:回顾分析2010年5月至2016年8月收治的52例腹壁疝患者的临床资料,其中27例行LVHR,25例行开放手术。结果:两组手术时间(65.4±18.7)min vs.(84.5±31.5)min]、术后住院时间(6.3±1.8)d vs.(9.8±6.2)d]、术后第1天疼痛评分VAS(3.4±1.1)vs.(6.4±1.5)]差异有统计学意义(P0.05),术后1周及1个月的疼痛评分差异无统计学意义(P0.05)。两组并发症发生率(22.2%vs.20.0%)差异无统计学意义(P0.05),腔镜组住院费用高于开放组(P0.05)。术后随访2~24个月,中位随访时间12个月,两组均无复发病例。结论:LVHR修补腹壁疝是安全、可行的,具有患者创伤小、康复快等优点,值得临床推广。

Comparative effectiveness research of laparoscopic versus open herniorrhaphy for ventral hernias

Objective:To evaluate the clinical application effect of laparoscopic ventral hernia repair (LVHR) and open ventral hernia repair (OVHR) for the treatment of abdominal wall hernia.Methods:The clinical data of 52 patients with hernia of abdominal wall between May 2010 and Aug.2016 were retrospectively analyzed.27 patients underwent LVHR,25 patients underwent OVHR.Results:The laparoscopic and the open group's average operation time was (65.4±18.7) min and (84.5±31.5) min respectively,the average hospital stay after surgery was (6.3±1.8) d and (9.8±6.2) d,the VAS pain score of two groups on the first day after operation was (3.4±1.1) and (6.4±1.5),the differences were statistically significant (P<0.05).The pain score of 1 week and 1 month after operation showed no statistically significant difference (P>0.05).The hospitalization cost of laparoscopic group was more than that of open group (P<0.05).After a follow up of 2-24 months (12 months in median),incidence of complications in the two groups were 22.2% and 20.0% without recurrence cases,there was no statistically significant difference (P>0.05).Conclusions:The LVHR is safe and feasible in repairing abdominal wall hernia with advantages of little injury and pain,rapid recovery.LVHR is worthy of clinical promotion.