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中华疝和腹壁外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 437 -440. doi: 10.3877/cma.j.issn.1674-392X.2023.04.015

论著

腹腔镜完全腹膜外疝修补术治疗腹壁切口疝的临床疗效
刘文宇()   
  1. 100730 首都医科大学附属北京同仁医院手术室
  • 收稿日期:2023-05-22 出版日期:2023-08-18
  • 通信作者: 刘文宇
  • 基金资助:
    首都医科大学教育教学改革研究课题(2022JYY392)

Clinical efficacy of laparoscopic totally extra-peritoneal hernia repair for incisional hernia of the abdominal wall

Wenyu Liu()   

  1. Operating Room, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2023-05-22 Published:2023-08-18
  • Corresponding author: Wenyu Liu
引用本文:

刘文宇. 腹腔镜完全腹膜外疝修补术治疗腹壁切口疝的临床疗效[J/OL]. 中华疝和腹壁外科杂志(电子版), 2023, 17(04): 437-440.

Wenyu Liu. Clinical efficacy of laparoscopic totally extra-peritoneal hernia repair for incisional hernia of the abdominal wall[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(04): 437-440.

目的

探讨腹腔镜完全腹膜外疝修补术(TEP)治疗腹壁切口疝的临床疗效。

方法

选择2022年4月至2023年4月,于首都医科大学附属北京同仁医院拟行腹壁切口疝患者138例。依据手术方式的不同分为腹腔镜组,54例,实施TEP,对照组84例,采用开放性补片修补术。对比分析两组患者的围手术期情况及术后1周复发率。

结果

腹腔镜组并发症(切口愈合不良、切口感染、阴囊水肿、阴囊血肿、尿潴留及异物感硬结)发生率低于对照组,差异有统计学意义(P<0.05)。腹腔镜组的手术时间、住院时间、术中出血量及复发率低于对照组,差异有统计学意义(P<0.05)。腹腔镜组术后24 h疼痛视觉模拟评分(VAS)低于对照组,差异有统计学意义(P<0.05),48 h VAS评分两组比较差异无统计学意义。

结论

TEP治疗腹壁切口疝具有手术时间短、创伤小、术后恢复快、并发症少等安全可靠的优点。

Objective

To investigate the clinical efficacy of laparoscopic totally extra-peritoneal hernia repair (TEP) for incisional hernia of the abdominal wall.

Methods

A total of 138 patients with incisional hernia of the abdominal wall were selected from April 2022 to April 2023 in Beijing Tongren Hospital, Capital Medical University. According to different surgical methods, 54 patients who underwent TEP were divided into the laparoscopic group and 84 patients who underwent open mesh repair were divided into the control group. The differences between the two groups were compared in terms of perioperative condition and recurrence rate one week after operation.

Results

The patients in the laparoscopic group had lower incidence of complications (poor incisional healing, incisional infection, scrotal edema, scrotal hematoma, urinary retention and foreign body sensation hardening) than the control group, and the difference was statistically significant (P<0.05). The operative time, hospital stay, intraoperative bleeding, and recurrence rate were lower in the laparoscopic group than those in the control group, with statistically significant differences (P<0.05). The visual analogue scale (VAS) scores were lower in the laparoscopic group than that in the control group at 24 h postoperatively, with statistically significant differences (P<0.05). There was no significant difference in VAS score between the two groups at 48 hours after operation.

Conclusion

Laparoscopic TEP hernia repair was safe and reliable, with the advantages of short operation time, less trauma, rapid postoperative recovery, and few complications.

表1 两组患者一般资料比较[例(%)]
表2 两组患者术后并发症比较
表3 两组患者手术效果比较(±s
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