经腹腔途径腹膜前补片置入术和无张力疝修补术治疗嵌顿性腹股沟疝的对照分析

目的探讨经腹腔途径腹膜前补片置入术（TAPP）治疗嵌顿性腹股沟疝的安全性、有效性及优势。方法将124例成年嵌顿性腹股沟疝患者按随机配对法分为两组，观察组56例，采用腹腔镜下复位＋TAPP治疗；对照组68例，采用切开复位＋无张力疝修补术治疗。记录两组手术时间、住院时间、下床活动时间、住院费用、复发率及并发症情况，并进行统计学分析。结果观察组所有病例均在腹腔镜下完成手术，无中转开放手术。观察组手术时间、住院时间、下床活动时间均短于对照组（37．52±7．78）min比（44．23±11．32）min、（4．53±O．89）d比（6．85±2．03）d、（9．30±2．65）h比（12．63±3．97）h]，差异有统计学意义（P〈0．05）。观察组住院费用多于对照组（9324±599）元比（7203±507）元]，差异有统计学意义（P〈0．05）。两组并发症发生率比较差异无统计学意义（P〉O．05）。术后随访1年，观察组无复发，对照组有1例复发，两组复发率比较差异无统计学意义（P〉0．05）。结论TAPP治疗嵌顿性腹股沟疝微创、恢复快，是安全有效的，住院费用略高，复发率与无张力疝修补术相当。

Comparative analysis of transabdominal preperitoneal prosthetic and tension-free hernioplasty in treatment of incarcerated hernia

Objective To investigate the security and validity of transabdominal preperitoneal prosthetic （TAPP） in treatment of incarcerated hernia. Methods One hundred and twenty-four patients with incarcerated hernia were divided into 2 groups by random pair method： observation group with treatment of laparoscopie reposition and TAPP （56 cases） and control group with treatment of open reduction and tension-free hemioplasty （68 cases）. The operative time, hospital stay, bed time, hospital costs, recurrence rate and complication were compared between the 2 groups. Results All patients in observation group werereceived laparoscopic surgery successfully. The operation time, hospital stay, bed time in observation group were significantly shorter than those in control group （37.52 ±7.78） min vs. （44.23±11.32） min, （4.53 ± 0.89） d vs. （6.85 ±2.03） d, （9.30 ±2.65） h vs. （ 12.63 ± 3.97） hi ,there were statistical differences （P 〈 0.05）. The hospital costs in observation group was significantly higher than that in control group （9 324 ± 599） yuan vs. （7 203 ± 507） yuan ], there was statistical difference （P 〈 0.05）. There was no statistical difference in complication rate between the 2 groups （P 〉 0.05 ）. Follow-up 1 year,there was no recurrence patient in observation group and 1 patient was recurrence in control group, there was no statistical difference between the 2 groups （P 〉 0.05）. Conclusions TAPP is safe and effective with advantages of mini-invasion, quicker recovery but more hospital costs in treatment of incarcerated hernia. The recurrence rate of TAPP is similar to tension-free hernioplasty.