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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) ›› 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. 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. 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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殷响, 陈岩, 孔维元, 张奇, 王琼琼, 于洪亮. 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[J]. 中华疝和腹壁外科杂志(电子版), 2022, 16(01): 108-110.

Xiang Yin, Yan Chen, Weiyuan Kong, qi Zhang, Qiongqiong Wang, Hongliang Yu. Clinical effect of Needle Ports laparoscopic transabdominal preperitoneal (NP-TAPP) repair in treatment of inguinal hernia[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(01): 108-110.

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
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