两种无张力疝修补术在治疗成人腹股沟斜疝中的对比

目的 比较开放式无张力疝修补术与腹腔镜疝修补术在治疗成人斜疝中的疗效差异。方法 回顾性分析和比较1999年1月～2004年7月，完成的两种不同无张力成人斜疝修补术172例（A组：开放式无张力修补术90例，B组：腹腔镜无张力修补术82例）的手术并发症、术后恢复情况、费用及复发率等。结果 两种术式复发率差异无显著性，B组术后恢复快于A组，手术并发症B组少于A组，费用B组高于A组。结论 两种疝修补术在治疗成人斜疝中均疗效确切，复发率低；腹腔镜疝修补术虽有很多优点，并可作为双侧疝、复发疝、滑动性疝、下腹部有手术疤痕等疝患者的首选，但还不能完全取代开放式无张力疝修补术，选用何种手术方式应个体化。

Comparison of two tension-free herniorrhaphies in treatment of adult indirect inguinal hernia

[Objective] To compare the differences of the clinic outcome between the two tension-free herniorrhaphies in the treatment of adult indirect inguinal hernia (IIH). [Methods] To analyse retrospectively postoperative complications, recovery process, fee, recurrence rate etc of the 172 cases of the two tension-free herniorrhaphies, we had performed since January 1999 to July 2004(group A: 90cases of opening tension-free herniorrhaphy;group B: 82 cases of transabdominal preperitoneal (TAPP) hernia repair and total extraperitoneal (TEP) hernia repair. [Results] There was no significant differences in recurrence rate between the two groups, the recovery process in group B was much faster than that in group B. The complications in group A were more common than that in group B, but the fee in group B was much higher than in group A. [Conclusions] The two tension-free herniorrhaphies in the treatment of adult indirect inguinal hernia have excellent outcome and low recurrence rate. Even though the laparoscopic herniorrhaphy have many advantages and especially suitable for bilateral IIH, recurrent IIH, sliding hernia and the IIH-patients with big scar in hernia area etc, it still can not completely replace the opening tension-free herniorrhaphy. Which kind of operation should be performed must base on the different conditions of the patients.