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中华疝和腹壁外科杂志(电子版) ›› 2022, Vol. 16 ›› Issue (06) : 695 -698. doi: 10.3877/cma.j.issn.1674-392X.2022.06.019

临床论著

完全腹膜外疝修补术与Lichtenstein术治疗腹股沟疝的疗效比较
马勇1, 罗莹1, 杨建栋1, 姜嵩1, 罗逸潜1,()   
  1. 1. 116011 辽宁大连,中国人民解放军联勤保障部队第967医院普外科
  • 收稿日期:2022-06-30 出版日期:2022-12-18
  • 通信作者: 罗逸潜
  • 基金资助:
    辽宁省科学技术计划项目(2015010412-301)

Comparison of total extraperitoneal herniorrhaphy and Lichtenstein surgery in the treatment of inguinal hernia

Yong Ma1, Ying Luo1, Jiandong Yang1, Song Jiang1, Yiqian Luo1,()   

  1. 1. Department of General Surgery, the 967th Hospital of the Joint Logistic Support Force of the PLA, Dalian Liaoning 116012, China
  • Received:2022-06-30 Published:2022-12-18
  • Corresponding author: Yiqian Luo
引用本文:

马勇, 罗莹, 杨建栋, 姜嵩, 罗逸潜. 完全腹膜外疝修补术与Lichtenstein术治疗腹股沟疝的疗效比较[J/OL]. 中华疝和腹壁外科杂志(电子版), 2022, 16(06): 695-698.

Yong Ma, Ying Luo, Jiandong Yang, Song Jiang, Yiqian Luo. Comparison of total extraperitoneal herniorrhaphy and Lichtenstein surgery in the treatment of inguinal hernia[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2022, 16(06): 695-698.

目的

探讨腹腔镜完全腹膜外疝修补术(TEP)与Lichtenstein术治疗腹股沟疝的临床疗效及并发症影响。

方法

回顾性分析2018年6月1日至2021年6月1日中国人民解放军联勤保障部队第967医院普外科收治的126例腹股沟疝患者临床资料。74例患者接受TEP手术,为TEP组;52例接受Lichtenstein术,为开放组;对比2组手术相关指标、术后1周并发症(阴囊水肿、切口感染、尿潴留、暂时性神经感觉异常)发生率及术后不同时间腹股沟区视觉模拟评分(VAS)。

结果

TEP组手术时间、住院费用明显高于开放组,术中出血量、住院时间,术后1周并发症(阴囊水肿、切口感染、尿潴留、暂时性神经感觉异常)发生率明显低于开放组,差异有统计学意义(P均<0.05)。术后24 h及1、3个月腹股沟区VAS评分明显低于开放组,差异有统计学意义(P均<0.05);但术后6个月VAS评分与开放组相比差异无统计学意义(P>0.05)。

结论

TEP手术具有创伤小、疼痛轻、恢复快、住院时间短、并发症发生率低的特点,治疗效果明显优于Lichtenstein术,但其费用高、手术用时长,临床应用中应根据患者自身情况及手术医师所掌握的手术技能选择合适的手术方式。

Objective

To study the clinical effects and complications of laparoscopic total extraperitoneal hernia repair (TEP) and Lichtenstein hernia repair for inguinal hernias.

Methods

Retrospective analysis of the clinical data of 126 patients with inguinal hernias admitted to the General Surgery Department of the 967th Hospital of the Joint Logistic Support Force of the PLA from June 1, 2018 to June 1, 2021. 74 patients received TEP operation, in the TEP Operation Group; 52 patients received Lichtenstein operation, in the Open Operation Group; The incidence of postoperative complications (scrotal edema, incision infection, urinary retention, temporary neurosensory disturbance), and visual analogue scale (VAS) pain in the inguinal area were compared between the two groups, to evaluate and analyze the advantages of laparoscopic total extraperitoneal hernia repair.

Results

Compared with the open group, the operation time and hospital expenses of the TEP group were significantly higher (P<0.05); intraoperative blood loss, hospital stay, and postoperative complications (scrotal edema, incision infection, the incidence rates of urinary retention, temporary neurosensory abnormalities) in the TEP group were significantly lower; the VAS scores of the inguinal region in the TEP group were significantly lower at 24 hours, 1 month and 3 months after operation. There were all statistical significance (P<0.05). There was no significant difference in the inguinal region VAS score between the two groups at 6 months after operation (P>0.05).

Conclusion

TEP has the characteristics of less trauma, less pain, faster recovery, shorter hospital stay, and lower complication rate. The therapeutic effect of TEP is obviously better than the Lichtenstein procedure, but the operation time and hospital expenses of the TEP group were significantly higher. In clinical application, the appropriate operation method should be selected according to the patient's own situation and the surgical skills mastered by the surgeon.

表1 2组患者一般临床资料对比[例(%)]
表2 2组患者手术相关指标比较(±s
表3 2组患者术后1周并发症比较[例(%)]
表4 2组患者术后疼痛程度视觉模拟评分比较(分,±s
[1]
Gong W, Li J. Operation versus watchful waiting in asymptomatic or minimally symptomatic inguinal hernias: The meta-analysis results of randomized controlled trials[J]. Int J Surg, 2018, 52(5): 120-125.
[2]
Nagahisa Y, Kawashima R, Matsumoto R, et al. Feasibility of a novel tacking method of securing mesh in transabdominal preperitoneal inguinal hernia repair: Secure tacking against recurrence[J]. Asian J Endosc Surg, 2018, 11(4): 385-391.
[3]
金璐, 叶静, 郭自成, 等. 抗凝治疗患者嵌顿性腹股沟疝急诊手术术式选择及其应用研究[J]. 中华急诊医学杂志, 2020, 29(12): 1641-1642.
[4]
Fujinaka R, Urade T, Fukuoka E, et al. Laparoscopic transabdominal preperitoneal approach for giant inguinal hernias[J]. Asian J Surg, 2018, 42(1): 414-419.
[5]
陆鉴, 甘建春, 黄鹄, 等. 局麻下腹膜前间隙疝无张力修补术与李金斯坦疝无张力修补术治疗腹股沟疝效果比较[J]. 浙江医学, 2020, 42(11): 1181-1183.
[6]
中华医学会外科学分会疝与腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊断和治疗指南(2018年版)[J/OL]. 中华疝和腹壁外科杂志(电子版), 2018, 12(4): 244.
[7]
余磊, 魏寇准, 刘志刚, 等. 不同手术入路对腹腔镜下腹股沟疝修补术临床疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2021, 15(4): 361-365.
[8]
Ansari MM. Retzius space: not a single anatomical entity: new insights, simplified and illustrated in a laparoscopic study during TEPP hernioplasty for inguinal hernia[J]. Ann Int Med Den Res, 2017, 4(1): 63-73.
[9]
Ansari MM. Transversalis fascia and preperitoneal fascia: a laparoscopic study of live surgical anatomy during TEPP hernioplasty-final report and literature review[J]. Ann Int Med Den Res, 2017, 3(6): 19-32.
[10]
李绍杰, 杨子昂, 李绍春, 等. 生物材料在不同年龄腹股沟疝患者中应用价值的探讨[J]. 老年医学与保健, 2020, 26(4): 602-605.
[11]
唐健雄,李绍杰,李绍春.对我国疝与腹壁外科专业发展的思考[J]. 中华消化外科杂志, 2021,20(1):98-101.
[12]
李芳, 王峻峰. 腹腔镜经腹腹膜前疝修补术治疗腹股沟复发疝的临床疗效及安全性[J/OL]. 中华疝和腹壁外科杂志(电子版), 2021, 15(4): 4211-429.
[13]
申亚伟, 黄新, 马小安, 等. TEP与Lichtenstein在疝修补术中的临床对比研究[J]. 河北医学, 2017, 23(6): 927-930.
[14]
彭延春, 赵司卫, 刘祥尧. TAPP、TEP及IPOM 3种疝修补术治疗腹股沟复发疝的临床对比研究[J]. 实用医学杂志, 2021, 35(6): 950-953.
[15]
陈雷, 曾春辉, 彭传林, 等. 腹腔镜腹股沟疝修补术中缝合关闭疝环缺损对术后预后效果分析研究[J]. 武警后勤学院学报(医学版), 2021, 30(9): 123-124.
[16]
王志坚, 徐志, 尧茂付, 等. 自固定补片在腹腔镜腹股沟疝修补术与开放式无张力腹股沟疝修补术中的应用价值[J]. 实用临床医药杂志, 2020, 24(4): 84-86.
[17]
Li Xiaoteng, Dai Peng, Luo Jianbo, et al. Clinical Efficacy Analysis of TEP Laparoscopic Inguinal Hernia Repair[J]. Mod Diagn Treat, 2021, 32(15): 2356-2358.
[18]
茹东跃, 陈德兴. 腹膜前间隙解剖结构在腹腔镜完全腹膜外疝修补术中的应用[J]. 中国微创外科杂志, 2020, 20(12): 1111-1113.
[19]
Asakage N. Paradigm shift regarding the transversalis fascia, preperitoneal space and Retzius' space[J]. Hernia, 2018, 22(3): 499-506.
[20]
董泾青. 膜解剖理念在腹腔镜完全腹膜外疝修补术中的应用[J/OL]. 中华疝和腹壁外科杂志(电子版), 2020, 14(5): 472-475.
[21]
李航宇. 从生物力学角度重新解读腹壁重建[J]. 中国实用外科杂志, 2021, 41(4): 379-383.
[22]
李绍春,顾岩,胡星辰,等.不同聚丙烯补片在成人腹股沟疝修补术中的应用价值[J]. 中华消化外科杂志, 2020,19(7):767-772.
[23]
立全晰, 沈宇, 万伟, 等. 聚丙烯带网塞补片无张力修补腹股沟疝后腹壁力学和疼痛变化[J]. 中国组织工程研究, 2021, 25(4): 548-552.
[24]
吴浩瀚, 吴文涌, 张顺, 等. 腹腔镜下不同术式和开放手术疝修补术对腹股沟疝治疗效果的前瞻性随机对照研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2021, 15(1): 35-39.
[25]
何礼安, 雷焦. 腹腔镜与开放手术治疗嵌顿性腹股沟疝的临床疗效对比[J]. 华南国防医学杂志, 2021, 35(8): 609-610, 616.
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