腹腔镜下完全腹膜外无张力疝修补术的应用价值

目的比较腹腔镜下完全腹膜外无张力疝修补术（TEP）与开放式平片无张力疝修补术（Lichtenstein术）治疗腹股沟疝的疗效。方法回顾分析236例腹股沟疝病例，随机分为TEP组132例和开放组104例。比较两组临床指标、术后并发症发生率及复发率等。结果与开放纽相比，TEP组初次下床活动时间，恢复正常活动时间，术后住院时间明显缩短，术后3d使用止痛药物次数少（P〈0．01）。慢性疼痛，术后异物感、硬结，并发症例数均较少（P〈0．05）。术后复发率及平均手术时间二者比较，差异均无统计学意义（P〉0．05），其中双侧疝手术时间短于对照组。TEP组住院费用相对较高（P〈0．05）。结论TEP术具有创伤性小、安全、术后住院时间短、术后并发症少、恢复快等诸多优点，值得临床推广。

Value of totally extraperitoneal prosthetic operation under laparoscopic control

Objective ] This study was carried out to compare the therapeutic effects on the treatment of inguinal hernia between total extraperitoneal prosthetic operation （TEP group） and opening tension-free repair operation （opening group）. Methods ] A total of 236 cases of inguinal hernia were treated either by TEP method （132 cases） or opening method （104 cases）. Several clinical indicators, operative complications and recurrence rate were compared between the two methods. Resluts ] Compared to the opening group the first ambulation timem,the time for returning to normal activity and postoperative hospital stay for the TEP group was significantly shorter.The use of pain medication after 3 days in TEP group was less（P〈0.01）.The TEP group also felt less chronic pain,postoperative foreign objective sensation and induration,and has low rate of complications.Between the two groups,the reccurance rate was no statiscally significant difference（P〉0.05）. There was no difference in the average operative time（P〉0.05）,but the TEP group have shorter surgical time in the bilateral hernia cases.The TEP group had relatively higher hopitalization cost. Conclusion ] The TEP method is less invasive, safer, shorter postoperative hospital stay, fewer complications,faster recovery,and many other advantages. So this operation deserves to be promoted in clinical practice.