聚丙烯非编织与编织补片应用于经腹腹膜前疝修补术的对比研究

目的 比较聚丙烯非编织与编织补片应用于经腹腹膜前疝修补术（TAPP）的疗效和并发症.方法 回顾性分析2010年1月至2013年1月,南京市浦口医院对93例腹股沟疝患者行TAPP术,其中应用非编织3D补片48例（观察组）,编织3D补片45例（对照组）,分析比较二组手术时间、术后住院时间、术后并发症发生情况,并随访慢性疼痛、异物感及复发情况.结果 二组患者平均手术时间、术后住院时间无差异,术中均无脏器及血管损伤,术后无感染及肠梗阻等并发症.术后近期主要并发症为血清肿,观察组4例（8.3%）,对照组5例（11.1%）,二组差异无统计学意义（χ2=0.205,P=0.735）.术后随访6～36个月,二组均无复发.观察组组无慢性疼痛病例,对照组出现慢性疼痛4例（8.9%）,观察组慢性疼痛发生率明显低于对照组（χ2=4.458,P=0.035）;对照组有1例术后有异物感.结论 使用非编织和编织3D补片行腹腔镜腹股沟疝修补术均疗效确切,非编织3D补片术后慢性疼痛发生率低于编织补片.

Comparison of unbraid and braid mesh in treatment of inguinal hernia repaired by TAPP

Objective To compare the clinical outcome of unbraid vs braid mesh in treatment of inguinal hernia repaired by TAPP. Methods From January 2010 to January 2013, 93 patients with inguinal hernia were applied with TAPP in Nanjing Pukou Yiyuan. The unbraid meshes were used for herniaplasty in 48 patients （the observation group） and braid meshes were used in the other 45 patients （the control group）. Intraoperative and postoperative complications and hernia recurrence were compared. Results All the TAPP were successful. The mean operative time and duration of postoperative hospital stay were comparable between the two groups. Intra-operative organ or vessel injury, postoperative infection and intestinal obstruction were not found in both groups. Seroma was occurred in 4 cases （8. 3% ） of the observation group and 5 cases （ 11.1% ） of the control group with no significant difference （2 = 0. 205, P = 0. 735）. During the 6 to 36 month of follow-ups,no patients had recurrence;while no patients was observed with chronic pain in the observation group and 4 （8.9%） patients in the control group with significant difference（x2 =4. 458,P =0. 035）. Sensation of foreign body was found in the one patient of braid group. Conclusions TAPP using unbraid or braid mesh is available. The incidence of chronic pain was lower by using unbraid mesh.