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中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (05) : 461 -464. doi: 10.3877/cma.j.issn.1674-392X.2019.05.019

所属专题: 文献

临床论著

腹腔镜完全腹膜外疝修补术与腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的疗效
宋文玖1,(), 吕浩鹏1, 陈建平1, 凌玲2   
  1. 1. 611430 四川省,新津县人民医院普外科
    2. 400000 重庆市红十字医院(江北区人民医院)产科
  • 收稿日期:2019-01-09 出版日期:2019-10-18
  • 通信作者: 宋文玖
  • 基金资助:
    重庆市医学科研计划项目合同(2011-2-426)

Comparison of application effect of laparoscopic total extraperitoneal repair and transabdominal preperitoneal repair in inguinal hernia

Wenjiu Song1,(), Haopeng Lv1, Jianping Chen1, Ling Ling2   

  1. 1. Department of General Surgery, Xinjin People's Hospital, Chengdu 611430, China
    2. Department of Obstetrics, Chongqing Red Cross Hospital (Jiangbei People's Hospital), Chongqing 400000, China
  • Received:2019-01-09 Published:2019-10-18
  • Corresponding author: Wenjiu Song
  • About author:
    Corresponding author: Song Wenjiu, Email:
引用本文:

宋文玖, 吕浩鹏, 陈建平, 凌玲. 腹腔镜完全腹膜外疝修补术与腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2019, 13(05): 461-464.

Wenjiu Song, Haopeng Lv, Jianping Chen, Ling Ling. Comparison of application effect of laparoscopic total extraperitoneal repair and transabdominal preperitoneal repair in inguinal hernia[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2019, 13(05): 461-464.

目的

比较腹腔镜完全腹膜外疝修补术(TEP)与腹腔镜经腹腹膜前疝修补术(TAPP)在腹股沟疝中的应用效果。

方法

回顾性分析2015年2月至2018年1月,新津县人民医院收治的80例腹股沟疝患者的临床资料,根据手术方式不同将其分为试验组及对照组,每组40例。试验组行TEP,对照组行TAPP,2组均行为期1年的随访。比较2组手术临床指标、术后疼痛情况,并统计2组术后并发症发生率。

结果

试验组手术时间及铺片耗时分别为(60.27±4.23)min及(25.31± 4.86)min显著短于对照组(73.18±5.62)min及(28.73±5.12)min,差异有统计学意义(t=11.608、3.064,P<0.001、P=0.003);试验组住院时间及胃肠功能恢复时间分别为(3.38±0.78)d及(15.08±0.91)min与对照组(3.14±0.71)d及(14.79±0.83)min比较,差异无统计学意义(t=1.439、1.489,P=0.154、0.140)。自术前至术后5个月试验组及对照组VAS评分均呈下降趋势,差异有统计学意义(F=252.345、181.841,P均<0.001),且术后2及5个月各时间点VAS评分试验组显著低于对照组(t=4.135、4.711,P均<0.001),术前及术后1 d时间点试验组VAS评分与对照组比较,差异均无统计学意义(t=1.645、1.444,P=0.869、0.153)。试验组并发症发生情况2(5%)与对照组8(20%)比较,差异无统计学意义(χ2=2.857,P=0.091)。

结论

腹腔镜全腹膜外自固定补片植入术较经腹股沟腹膜前补片植入术可有效缩短手术时间及铺片时间,且术后疼痛较轻、并发症发生率较低。

Objective

To compare the application effect of laparoscopic total extraperitoneal (TEP) repair and transabdominal preperitoneal (TAPP) repair in the inguinal hernia.

Methods

The clinical data of 80 patients with inguinal hernia admitted to Xinjin People's hospital from February 2015 to January 2018 were retrospectively analyzed, and they were divided into the study group and the control group according to the different operation method, with 40 cases in each group. The study group was treated with TEP repair, and the control group underwent TAPP repair. Both groups were followed up for 1 year. The clinical indicators and postoperative pain of the two groups were compared, and the postoperative complications occurrence rate was noted.

Results

The operation time and mesh implantation time in the study group were significantly shorter than those in the control group [(60.27±4.23) minutes vs (73.18±5.62) minutes, (25.31±4.86) minutes vs (28.73±5.12) minutes, t=11.608, 3.064, P<0.001, P=0.003]. There were no significant differences in the hospitalization time and the gastrointestinal function recovery time between the two groups [(3.38±0.78) days vs (3.14±0.71) days, (15.08±0.91) minutes vs (14.79±0.83) minutes, t=1.439、1.489, P=0.154、0.140]. The VAS scores of the 2 groups showed a downward trend from before operation to 5 months after operation (F=252.345, 181.841, all P<0.001). At each time point of 2 months and 5 months after the surgery, the study group showed lower VAS score than the control group (t=4.135, 4.711, all P<0.001). There was no significant difference in the incidence of complications between the study group and the control group (5% vs 20%, χ2=2.857, P=0.091).

Conclusion

TEP repair can effectively shorten the operative time and mesh implantation time compared with TAPP repair, with less postoperative pain and low incidence of complications.

表1 2组临床指标比较(±s
表2 2组手术前后疼痛视觉模拟评分比较(分, ±s
[1]
周敏, 林虹, 韩宇. 腹股沟疝术后10%盐水冰袋冷敷联合疝气袋的使用与普通沙袋压迫的临床对比[J]. 护士进修杂志, 2014, 29(8): 763-764.
[2]
朱雁飞, 蒋志阳, 陶国青. 不同手术方式治疗腹股沟疝的疗效分析[J]. 贵州医药, 2017, 41(12): 1277-1278.
[3]
Eriksen JR, Gögenur T, Rosenberg J. Choice of mesh for laparoscopic ventral hernia repair[J]. Hernia, 2007, 11(6): 481-492.
[4]
李亮. 实用腹股沟疝外科学[M]. 西安: 世界图书出版西安有限公司, 2014: 121-123.
[5]
Liu Y, Shen Y, Chen J. Effects of non-woven mesh in preperitoneal tension-free inguinal hernia repair: a retrospective cohort study.[J]. Minerva Chir, 2017, 72(4): 311-316.
[6]
李义亮, 苏福增, 克力木, 等. 腹腔镜完全腹膜外补片植入术治疗腹股沟疝的临床体会[J]. 临床外科杂志, 2016, 24(11): 847-848.
[7]
周志涛, 毛常青, 吕培标, 等. 腹腔镜经腹腹膜前补片植入术治疗腹股沟疝的临床应用研究[J]. 四川医学, 2016, 37(3): 274-276.
[8]
葛永祥, 刘庆宏, 曹赣, 等. 腹腔镜全腹膜外不钉合补片植入术与经腹股沟腹膜前补片植入术临床疗效对比分析[J]. 实用临床医药杂志, 2015, 19(19): 99-100.
[9]
王帆, 靳翠红, 赵凤林, 等. 自固定补片与钉合固定补片在巨大腹股沟疝行腹腔镜经腹腹膜前疝修补术中的对比研究[J]. 首都医科大学学报, 2017, 38(6): 911-914.
[10]
李君. 腹腔镜经腹膜前补片植入术治疗双侧腹股沟疝患者的围术期护理体会[J]. 中国医科大学学报, 2017, 46(5): 470-472.
[11]
Antunes AA, Dall'Oglio M, Crippa A, et al. Inguinal hernia repair with polypropylene mesh during radical retropubic prostatectomy: an easy and practical approach[J]. Brit J Urol Int, 2015, 96(3): 330-333.
[12]
刘进军, 张鹏, 余波, 等. Ⅰ、Ⅱ型腹股沟疝腹腔镜经腹腹膜前疝修补术中不固定补片与缝合固定补片的比较研究[J]. 腹腔镜外科杂志, 2017, 22(5): 368-372.
[13]
李海峰, 王荣寅. 3D-MAX补片在经腹腹膜前腹腔镜腹股沟疝修补术中的应用[J]. 西南国防医药, 2016, 26(7): 737-739.
[14]
Claus CMP, Rocha GM, Campos ACL, et al. Prospective, randomized and controlled study of mesh displacement after laparoscopic inguinal repair: fixation versus no fixation of mesh[J]. Surg Endosc, 2016, 30(3): 1134-1140.
[15]
吴国斌, 苏玉国, 王炬, 等. 腹腔镜腹股沟疝修补术中疝固定器与医用胶固定补片的疗效比较研究[J]. 现代中西医结合杂志, 2017, 26(25): 2789-2791.
[16]
周雪玲, 练贤惠, 刘健培. 腹腔镜全腹膜外腹股沟疝修补术中不同补片固定方式的中远期疗效对比研究[J/CD]. 中华普通外科学文献(电子版), 2017, 11(2): 104-107.
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