腹腔镜腹股沟疝修补术不同术式的初步临床体会

目的探讨腹腔镜腹股沟疝修补术的手术疗效。方法回顾性分析2009年1月~2010年6月我院采用通用3D补片行腹腔镜腹股沟疝修补术的34例患者的临床资料,其中经腹腔腹膜前腹腔镜腹股沟疝修补术(TAPP)21例,完全腹膜外腹腔镜腹股沟疝修补术(TEP)13例,随访时间8~24个月,比较两组的术中出血量、手术时间、术后下床活动和肛门排气时间、术后并发症、术后住院天数、术后复发率及远期慢性疼痛等临床效果。结果 34例手术全部顺利完成。两组术中出血量、肛门排气时间、住院天数、近期并发症组间差异无统计学意义(P均>0.05),TAPP组的手术时间、术后下床活动时间高于TEP组(P均<0.05)。随访期内TEP组和TAPP组均无复发。结论腹腔镜腹股沟疝修补术安全可行,根据医师经验选择不同术式可取得良好效果。

Primary clinical application of different laparoscopic surgical procedure for inguinal hernia repair

Objective To investigate the clinical results of laparoscopic surgical procedure for inguinal hernia repair. Methods Retrospective analysis of 34 patients who underwent laparoscopic inguinal hernia repair from January 2009 to June 2010 in the Ningbo Lihuili Hospital,including 21 cases treated with TAP]？ and 13 cases treated with TEP. Followed-up time from 8 to 24 months, the clinical results such as the amount of intraoperative blood loss, operative time, time to ambulation, passage of flatus, postoperative complications, postoperative hospital stay, recurrence rate and long-term chronic pain between the two groups were compared. Results Thirty-four cases had been performed, the amount of intraoperative blood loss, time to passage of flatus, postoperative hospital stay, postoperative complications between the two groups had no statistical differences （P all 〉0.05）, while the operative time and the time to ambulation of recurrent inguinal hernia repair of TAPP group were significantly higher than those of TEP group （P all〈0.05）, all cases had no recurrence. Conclusion Laparoscopic inguinal hernia repair is feasible and safe, according to the doctor experience choose different procedure could achieve good results.