腹腔镜经腹腹膜前和全腹膜外腹腔镜疝修补术的临床应用对比研究

目的：比较腹腔镜经腹腹膜前疝修补术（TAPP）与完全腹膜外腹腔镜疝修补术（TEP）治疗成人腹股沟疝的效果。方法回顾分析2007年10月～2013年02月收治的214例（235侧）腹股沟疝患者的临床资料，根据手术方式分为TAPP组58例和TEP组156例，将2组的临床资料进行比较分析。结果TEP组手术时间较短（P＜0.01）、住院费用较低（P＜0.01）。术后下床活动时间、住院时间、术后不适感方面，TAPP组与TEP组差异无统计学意义；TAPP组术中发现隐匿疝4例；术后并发症、复发率，TAPP组和TEP差异无统计学意义。结论TAPP与TEP各具优点，TAPP较TEP更利于发现隐匿疝。但是TEP较TAPP手术时间更短，住院费用更低。

Comparison on Clinical Application of Transabdominal Preperitoneal Prosthesis and Totally Laparoscopic Extraperitoneal Herniorrhaphy in Treating Inguinal Hernia

Objective To investigate clinical application of laparoscopic transabdominal preperitoneal （TAPP） prosthesis and laparoscopic totally extraperitoneal （TEP） prosthesis for adults. Methods We retrospectively ana-lyzed clinical data that covers 214 cases （235 sides, right and left）, from October 2007 to February 2013, in our laparoscopie surgery center. The patients who underwent laparoscopic inguinal hernia repair were randomly divid-ed into two groups according to surgical method, via laparoscopic transabdominal preperitoneal prosthesis group （TAPP group） of 58 cases, via laparoscopic totally extraperitoneal hernia repair group （TEP group） of 156 cases, and made a comparative analysis of clinical data between TAPP group and TEP group. Results TEP operative time was shorter （P〈0.01） with lower costs （P〈0.01）. Intra-operative ifndings in TAPP group detect 4 cases of occult hernia, but recurrence rates, time of post-operative ambulation, hospitalization time＆amp;post-operative discomfort, detection of occult hernia, complications were not signiifcantly different. Conclusion For occult inguinal hernia, TAPP is favorable over TEP. TEP is less time-consuming and less cost than TAPP.