腹腔镜经腹腹膜前疝修补术与开放式腹膜前间隙疝修补术的临床疗效

目的探讨腹腔镜经腹腹膜前疝修补术（transabdominalpreperitoneal，TAPP）及开放式腹膜前间隙疝修补术的治疗效果。 方法回顾性分析2016年1月至2017年8月，山西医科大学附属晋中第一人民医院102例腹沟股疝患者的临床资料，根据治疗方法不同分为试验组与对照组，每组51例。对照组采用开放式腹膜前间隙修补术治疗，试验组采用TAPP术修补质量。对2组患者的手术时间、术中出血量、住院时间，以及术后复发、疼痛、血肿、感染等不良事件的发生情况进行比较。 结果试验组患者住院时间为（4.65±0.78）d，明显短于对照组的（6.08±2.23）d，差异有统计学意义（P<0.05）。术后随访4～18个月，试验组未见复发及术后血肿、感染，术后慢性疼痛2例、术后阴囊积液1例；对照组中复发3例、术后血肿5例、感染3例、慢性疼痛6例、术后阴囊积液7例；2组并发症发生率比较，差异有统计学意义（P<0.05）。2组患者在手术时间、术中出血量方面对比，差异均无统计学意义（P>0.05）。 结论TAPP对于腹股沟疝的治疗效果优于开放式腹膜前间隙疝修补术，具有显著临床优势。

Clinical comparison between TAPP and open preperitoneal hernia repair for inguinal hernia

ObjectiveTo explore the clinical effect of laparoscopic transabdominalpreperitoneal (TAPP) and open preperitoneal hernia repair for inguinal hernia. MethodsAccording to the different treatment options, 102 cases of inguinal hernia who treated in the first people's hospital of Jinzhong were randomly divided into the TAPP group (51) and the control group (51). The control group were given the open preperitoneal hernia repair. The operation time, amount of bleeding, and hospital stay were noted, and the incidences of postoperative recurrence, pain, hematoma, and infection between the two groups were compared. ResultsThe hospital stay of the TAPP group was (4.65±0.78) days, obviously shorter than (6.08±2.23) days in the control group. The difference was statistically significant (P<0.05). After 4 to 18 months of follow-up, there were no recurrence, postoperative hematoma and infection in the TAPP group. 2 cases of chronic pain and 1 case of scrotal hydroceleoccurred in the TAPP group. There were 3 cases of recurrence and 5 cases of hematoma and 3 case of infection, 6 of chronic pain, and 7 cases of scrotal hydrocele in the control group; and the differences of the morbidity between the 2 groups were statistically significant (P<0.05). There were no differences in the operation time and the amount of bleeding during operation between two groups (P>0.05). ConclusionThe clinical effect of TAPP repair is better than open preperitoneal hernia repair for inguinal hernia.