从荟萃分析认识李金斯坦和腹膜前间隙修补术

目的比较李金斯坦（Lichtenstein）修补术与腹膜前间隙修补术的临床效果及并发症情况.方法 通过检索2000年1月至2012年11月PubMed、EMBase、Springer及Cochrane图书馆公开发表的英文文献,对纳入研究的14篇文献中采用Lichtenstein修补术与腹膜前间隙修补术的3 364例患者的复发率、慢性疼痛、局部麻木感、感觉异常、血肿/血清肿、切口感染、睾丸并发症、手术时间进行荟萃分析（meta-analysis）.结果 腹膜前间隙修补术组的复发率低于Lichtenstein组,差异有统计学意义OR=0.51,95%CI （0.29,0.89）];与Lichtenstein组比较,腹膜前间隙组的手术时间短,差异有统计学意义MD=-2.78,95%CI （-5.51,-0.006）].其他并发症,包括慢性疼痛、局部麻木感、感觉异常、血肿/血清肿、切口感染、睾丸并发症在二组之间差异无统计学意义.结论 开放腹膜前间隙腹股沟疝修补术是安全有效的修补技术,复发率更低,手术时间更短.

Comparison of open preperitoneal and Lichtenstein repair for inguinal hernia

Objective To examine the effectiveness of open preperitoneal approach and the Lichtenstein technique in the repair of inguinal hernia. Methods A total of 3 364 patients enrolled into 14 trials from January 2000 to November 2012 were included as a pooled meta analysis for assessment of effectiveness of inguinal hernia operation. Results Significant fewer cases of postoperative recurrence were observed in the group of preperitoneal technique compared with the Lichtenstein group OR = 0. 51,95% CI （0.29,0.89） ]. The operation time was shorter in the preperitoneal group compared with Lichtenstein group MD = -2. 78,95%CI （ -5.51, -0. 006）]. However, there was no statistically significant difference in the incidence of chronic pain, hematoma/seroma, wound infection, testicular problem, numbness and paresthesia. Conclusions The open preperitoneal approach is a safe and effective technique for inguinal hernia repair with less postoperative recurrence rates and shorter operation time.