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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (02) : 122 -125. doi: 10.3877/cma.j.issn.1674-392X.2020.02.007

所属专题： 文献；

临床论著

腹腔镜经腹腹膜前疝修补术与Lichtenstein术在成人腹股沟嵌顿疝的疗效
司仙科1, 次仁多吉2, 姚子涵2, 于昆3, 郑侃3, 华蕾3,†(), 张计训3, 杨佳华3   
  1. 1. 200062　上海中医药大学附属普陀医院普外科；857600　西藏自治区，日喀则市亚东县人民医院普外科
    2. 857600　西藏自治区，日喀则市亚东县人民医院普外科
    3. 200062　上海中医药大学附属普陀医院普外科
  • 收稿日期:2019-09-28 出版日期:2020-04-18
  • 通信作者: 华蕾
  • 基金资助:
    上海中医药大学附属普陀医院院级重点专科建设项目(2016112B)

Laparoscopic transabdominal preperitoneal prosthetic repair and Lichtenstein repair in the treatment of adult incarcerated inguinal hernia

Xianke Si1, Duoji Ciren2, Zihan Yao2, Kun Yu3, Kan Zheng3, Lei Hua3,†(), Jixun Zhang3, Jiahua Yang3   

  1. 1. Department of General Surgery, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China; Department of General Surgery, Yadong County People's Hospital, Tibet, Xigaze City 857600, China
    2. Department of General Surgery, Yadong County People's Hospital, Tibet, Xigaze City 857600, China
    3. Department of General Surgery, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China
  • Received:2019-09-28 Published:2020-04-18
  • Corresponding author: Lei Hua
  • About author:
    Corresponding author: Hua Lei, Email:
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司仙科, 次仁多吉, 姚子涵, 于昆, 郑侃, 华蕾, 张计训, 杨佳华. 腹腔镜经腹腹膜前疝修补术与Lichtenstein术在成人腹股沟嵌顿疝的疗效[J]. 中华疝和腹壁外科杂志(电子版), 2020, 14(02): 122-125.

Xianke Si, Duoji Ciren, Zihan Yao, Kun Yu, Kan Zheng, Lei Hua, Jixun Zhang, Jiahua Yang. Laparoscopic transabdominal preperitoneal prosthetic repair and Lichtenstein repair in the treatment of adult incarcerated inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2020, 14(02): 122-125.

目的

探讨腹腔镜经腹腹膜前疝修补术（TAPP）与Lichtenstein术在成人腹股沟嵌顿疝治疗中的临床应用比较。

方法

回顾分析2014年1月至2019年1月，上海中医药大学附属普陀医院急诊收治并完成无张力疝修补手术病例共82例成人腹股沟嵌顿疝患者临床资料，根据手术方式不同分为2组。观察组38例，行TAPP术；对照组44例，行Lichtenstein术。将2组手术时间，术后住院时间，术后疼痛评分，术后血清肿，术后其他并发症（复发、术后感染、术后肠坏死、出血），术后总费用等进行统计学分析。

结果

2组在术后血清肿及其他并发症上比较，差异无统计学意义（P>0.05）；研究组手术时间及住院费用明显高于对照组，差异有统计学意义（P<0.05）；研究组术后住院时间及术后疼痛评分低于对照组，差异有统计学意义（P<0.05）。

结论

TAPP术较Lichtenstein术手术时间长，术后总费用相对高，但其具有创伤小、疼痛轻、恢复快、复发率低等特点。

关键词: 嵌顿性疝，腹股沟, 腹腔镜经腹腹膜前疝修补术, Lichtenstein术
Objective

To compare the clinical application of laparoscopic transabdominal preperitoneal prosthetic (TAPP) repair and Lichtenstein repair in the treatment of adult incarcerated inguinal hernia.

Methods

A retrospective analysis of the clinical data of 82 patients with incarcerated inguinal hernia in Putuo Hospital from January 2014 to January 2019, according to different surgical methods at that time. 38 patients in the observation group were treated with TAPP, and 44 patients in the control group underwent Lichtenstein hernia repair. Statistical analysis was performed on the operation time, postoperative hospital stay, postoperative pain score, postoperative seroma, postoperative other complications (recurrence, postoperative infection, postoperative intestinal necrosis, hemorrhage) and total postoperative costs.

Results

There was no significant difference in postoperative seroma and other complications between the two groups (P>0.05). The operation time and hospitalization cost of the study group were significantly higher than those of the control group (P<0.05). The postoperative hospital stay and postoperative pain scores were lower than the control group, which was statistically significant (P<0.05).

Conclusion

TAPP has a longer operation a relatively high total postoperative cost than Lichtenstein repair. However, it has the characteristics of small trauma, light pain, rapid recovery and low recurrence rate.

Key words: Incarcerated hernia, inguinal, Laparoscopic trans-abdominal preperitoneal hernia repair, Lichtenstein
表1 2组患者一般资料比较
组别 例数 性别(例) 年龄(岁, ±s) 体质量指数(kg/m2, ±s) 嵌顿时间(h, ±s) 疝分类(例)
男性 女性 斜疝 直疝
观察组 38 36 2 65.00±10.79 23.17±2.88 6.84±2.27 35 3
对照组 44 43 1 66.00±10.78 22.24±3.02 7.02±2.27 43 1
t/χ2值 ? 0.017 ? 0.828 1.419 0.359 0.442
P值 ? 0.897 ? 0.410 0.160 0.721 0.506
表2 2组患者术后相关性资料比较
组别 例数 手术时间(min, ±s) 术后住院时间(d, ±s) 术后第1天疼痛VAS评分(分, ±s) 术后血清肿[例(%)] 术后其他并发症[例(%)] 总费用(元, ±s)
肠坏死 继发 复发 出血感染
观察组 38 108.55±31.26 3.68±1.79 2.95±0.57 5(13.16) 0 0 0 1(2.63) 14 435.45±2119.29
对照组 44 95.11±17.03 4.77±2.80 3.30±0.90 8(18.18) 1(2.27) 1(2.27) 1(2.27) 0 10 625.80±1883.77
t/χ2值 ? 2.462 2.063 2.050 0.386 0.132 8.618
P值 ? 0.016 0.042 0.044 0.535 0.716 <0.001
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