针孔腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的临床疗效

doi:10.3877/cma.j.issn.1674-392X.2022.01.026

中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (01) : 108 -110. doi: 10.3877/cma.j.issn.1674-392X.2022.01.026

临床论著

针孔腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的临床疗效

殷响¹, 陈岩¹, 孔维元¹, 张奇¹, 王琼琼¹, 于洪亮¹^,^†(

)

^1. 163712　黑龙江省大庆油田总医院微创，肿瘤外科

收稿日期:2020-09-17 出版日期:2022-02-18
通信作者: 于洪亮

Clinical effect of Needle Ports laparoscopic transabdominal preperitoneal (NP-TAPP) repair in treatment of inguinal hernia

Xiang Yin¹, Yan Chen¹, Weiyuan Kong¹, qi Zhang¹, Qiongqiong Wang¹, Hongliang Yu¹^,^†()

^1. Department of Minimally Invasive Surgery, Daqing Oil Field Hospital, Daqing 163712, Heilongjiang Province, China

Received:2020-09-17 Published:2022-02-18
Corresponding author: Hongliang Yu

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目的

探讨针孔腹腔镜经腹腹膜前疝修补手术（NP-TAPP）治疗腹股沟疝的安全性与可行性。

方法

回顾性分析2019年1月至2019年12月，大庆油田总医院行腹腔镜手术治疗的85例单侧腹股沟疝患者的临床资料。其中腹腔镜经腹腹膜前疝修补手术（TAPP）组患者53例，NP-TAPP组患者32例，观察记录2组的手术时间、术中出血量、术后住院时间、疼痛评分、腹壁瘢痕满意度及手术并发症等指标并进行对比分析。

结果

85例患者均顺利完成手术，2组手术时间、术中出血量、术后住院时间比较，差异均无统计学意义（P>0.05）；NP-TAPP组术后疼痛程度、腹壁瘢痕满意度均优于TAPP组，差异有统计学意义（P<0.05）。2组术后并发症发生率及复发率比较，差异均无统计学意义（P>0.05）。

结论

NP-TAPP治疗腹股沟疝安全有效，能最大程度减少手术创伤，提高术后腹壁切口美容效果。

关键词: 疝，腹股沟, 疝修补术, 腹腔镜, 针孔

Objective

To investigate the feasibility and safety of Needle Ports laparoscopic transabdominal preperitoneal (NP-TAPP) repair in treatment of the inguinal hernia.

Methods

The clinical data of 85 patients with inguinal hernia undergoing surgical treatment from January 2019 to December 2019 were retrospectively collected. Of the patients, 53 cases received laparoscopic TAPP repair (TAPP group) and 32 cases underwent Needle Ports laparoscopic TAPP repair (NP-TAPP group). The operating time, surgical bleeding amount, postoperative hospital stay time, pain score, abdominal wall scar satisfaction and surgical complications were observed, recorded and analyzed by comparison.

Results

All of the 85 patients underwent the NP-TAPP and TAPP procedures. There was no significant difference in operative time, intraoperative blood loss, or postoperative hospitalization days between the TAPP and NP-TAPP groups. The postoperative pain scores and scar satisfaction scores of the NP-TAPP group were significantly better than those in the TAPP group (P<0.05). No statistical difference was noted in the incidence of postoperative complications and recurrence rate between the two groups (all P>0.05).

Conclusion

Needle Ports laparoscopic transabdominal preperitoneal (NP-TAPP) repair is safe and effective in the treatment of inguinal hernia. This new technique has been performed stably with decreased postoperative pain and improved cosmetic results.

Key words: Hernia, inguinal, Herniorrhaphy, Laparoscopes, Needle ports

表1 2组患者围手术期相关指标比较（±s）

组别	例数	手术时间(min)	出血量(ml)	术后住院时间(d)	疼痛评分(分)	瘢痕满意度评分(分)
TAPP组	53	49.72±3.57	5.50±3.71	3.26±1.39	1.43±1.52	4.15±0.56
NP-TAPP组	32	51.50±4.15	4.80±3.95	2.93±1.49	0.99±1.37	5.76±0.79
P值		>0.05	>0.05	>0.05	<0.05	<0.05

表1 2组患者围手术期相关指标比较（±s）

组别	例数	手术时间(min)	出血量(ml)	术后住院时间(d)	疼痛评分(分)	瘢痕满意度评分(分)
TAPP组	53	49.72±3.57	5.50±3.71	3.26±1.39	1.43±1.52	4.15±0.56
NP-TAPP组	32	51.50±4.15	4.80±3.95	2.93±1.49	0.99±1.37	5.76±0.79
P值		>0.05	>0.05	>0.05	<0.05	<0.05

表2 2组患者术后并发症情况比较（例）

组别	例数	出血	脏器损伤	血清肿	肠梗阻	慢性疼痛	复发
TAPP组	53	1	0	3	1	2	0
NP-TAPP组	32	0	0	2	0	1	0
P值		>0.05	-	>0.05	>0.05	>0.05	-

表2 2组患者术后并发症情况比较（例）

组别	例数	出血	脏器损伤	血清肿	肠梗阻	慢性疼痛	复发
TAPP组	53	1	0	3	1	2	0
NP-TAPP组	32	0	0	2	0	1	0
P值		>0.05	-	>0.05	>0.05	>0.05	-

图1 主操作孔配套腹腔镜器械注：A为3 mm抓持钳；B为3 mm剪刀；C为3 mm分离钳；D为3 mm持针器；E为免戳卡2 mm单动抓钳；F为免戳卡2 mm双动抓钳；G为3 mm电钩钳；H为3 mm吸引器；I为3 mm镜头；J为3 mm戳卡

[1]	Carvalho GL, Loureiro MP, Bonim EA. Renaissance of minilaparoscopy in the NOTES and single port era: a tale of simplicity[J]. JSLS, 2011, 15(4): 585-588.
[2]	Carvalho GL, Loureiro MP, Bonim EA, et al. Minilaparoscopic technique for inguinal hernia repair combining transabdominal preperitoneal and totally extraperitoneal approaches[J]. JSLS, 2012, 16(4): 569-575.
[3]	Claus CM, Rocha GM, Campos AC, 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.
[4]	Firme WA, Carvalho GL, Lima DL, et al. Low-friction minilaparoscopy outperforms regular 5-mm and 3-mm instruments for precise tasks[J]. JSLS, 2015, 19(3): e2015. 00067.
[5]	Redan JA, Humphries AR, Farmer B, et al. Big operations using mini instruments: the evolution of mini laparoscopy in the surgical realm[J]. Surg Technol Int, 2015, 27: 19-30.
[6]	Shadduck PP, Paquentin EM, Carvalho GL, et al. Minilaparoscopy: instruments and economics[J]. Surg Technol Int, 2015, 27: 59-64.
[7]	Carvalho GL, Cavazzola LT. Can mathematic formulas help us with our patients?[J]. Surg Endosc, 2011, 25(1): 336-337.
[8]	Carvalho GL, Paquentin EM, Rao P. Should high-frequency electrosurgery be discouraged during laparoscopic surgery?[J]. Surg Endosc, 2016, 30(2): 401-403.

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[14]	杨建辉, 段文斌, 马忠志, 卿宇豪. 腹腔镜下脾部分切除术[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 314-314.
[15]	叶劲松, 刘驳强, 柳胜君, 吴浩然. 腹腔镜肝Ⅶ+Ⅷ段背侧段切除[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(02): 315-315.

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