腹腔镜经腹腔腹膜前网片疝修补术和开放疝修补术的随机对照研究

目的 通过一项随机临床试验对腹腔镜经腹腔腹膜前网片疝修补术（TAPP）和开放式疝修补术进行比较.方法 将101例腹股沟疝病人随机分成腹腔镜组（n=51）及开放手术组（n=50）,分别行TAPP和开放无张力疝修补术（Lichtenstein修补）,术后对病人进行随访,比较2组病人的相关参数.结果 腹腔镜组病人的手术时间比开放组长（P＜0.05）.2组术中并发症率无差异.术后1周的腹腔镜组的并发症率较开放组高（P＜0.05）.腹腔镜组病人的住院时间、恢复工作的时间比开放组短（P＜0.05）.术后1年,腹腔镜组病人发生慢性疼痛的比率与开放组相比差异无显著性（P＞0.05）.结论 TAPP治疗腹股沟疝是可行的、安全的,且在术后恢复方面较开放无张力修补更有优势.

Transabdominal preperitoneal laparoscopic inguinal herniorrhaphy repair versus open tention-free repair of groin hernia

Objective] To compare TAPP with open tention-free repair of groin hernia in a randomised research. Methods] 101 patients with groin hernia were randomly assigned to laparoscopic group (n =51) or open group (n =50), and were undergone the transabdominal preperitoneal (TAPP) or Lichtenstein repair respectively. We followed up the patients postoperatively and compared the correlative parameter. Results] In the laparoscopic repair group, duration of the operation was longer (P <0.05) than in the oper repair group. The difference of surgical complication between two groups was insignificant. At one week postoperatively, complications were found significantly more in laparoscopic group than in open group. In the laparoscopic group, length of postoperative stay was significantly shorter (P <0.05) than in the open repair group, and return to work was also significantly quicker (P <0.05). At one year after surgery, the difference of persistent groin pain between the two groups was insignificant. Conclusions] For patient with a groin hernia, TAPP is feasible, safe and has advantages over open tention-free repair in the postoperative recovery.