目的

探讨全腹腔镜Sublay 手术（TES）与腹腔镜腹腔内补片修补术（IPOM）治疗脐疝的效果及对患者术后短期生活质量的影响。

方法

回顾性分析2023 年6 月至2024 年2 月在首都医科大学附属北京朝阳医院行手术治疗的48 例脐疝患者的临床资料，依据手术方式分为TES 组11 例，IPOM 组37 例。对比2 组患者的手术资料、住院时间、住院费用及围手术期并发症等数据，评价手术效果，重点比较疼痛视觉模拟评分（VAS）和健康调查量表36（SF-36）评分结果，评价2组患者的术后短期生活质量。

结果

2 组患者的年龄、性别、体重指数、病程、合并症、抗凝及抗血小板药物的应用比较，差异均无统计学意义（P＞0.05）。2 组患者的手术时间、出血量、住院时间、并发症及复发率比较，差异均无统计学意义（P＞0.05），TES 组住院费用（19 133.36±4277.28）元，明显低于 IPOM 组（38 596.68±16 764.63）元，差异有统计学意义（P＜0.001）。术后疼痛方面，出院时IPOM 组VAS 评分≥3 分的患者30 例（81.1%），TES 组2 例（18.2%），差异有统计学意义（P＜0.001）。术后SF-36 评分结果显示，2 组患者的生活质量均有显著改善，但组间差异无统计学意义（P＞0.05）。

结论

TES 与IPOM 手术对脐疝均有良好治疗效果，并可改善患者术后短期生活质量。TES 在术后疼痛方面更具优势，住院费用更低。

Objective

To evaluate the therapeutic effects of totally endoscopic sublay repair（TES） compared to laparoscopic intraperitoneal onlay mesh repair （IPOM） in treating umbilical hernias and their influence on patients' short-term postoperative quality of life.

Methods

This study retrospectively analyzed clinical data of 48 patients with umbilical hernias who underwent surgical treatment in Beijing Chaoyang Hospital， Capital Medical University， between June 2023 and February 2024.Patients were categorized into two groups based on the surgical method： the TES group （11 cases）and the IPOM group （37 cases）.Surgical data， length of hospital stay， hospitalization costs， and perioperative complications were compared between the two groups to evaluate surgical outcomes， with a focus on visual analogue scale （VAS） and the Short-Form 36 （SF-36） scores to assess the short-term postoperative quality of life.

Results

No statistically significant differences were observed between the two groups in terms of age， sex， body mass index， disease duration， comorbidities， or the use of anticoagulant and antiplatelet medications （P＞0.05）.No significant differences were found in surgical time， blood loss， hospital stay length， complications， or recurrence rates between the two groups（P＞0.05）.The hospitalization cost for the TES group was （19 133.36±4277.28） yuan， significantly lower than that of the IPOM group （38 596.68±16 764.63 yuan）， with a statistically significant difference（P＜0.001）.Regarding postoperative pain， 30 （81.1%） patients in the IPOM group had a VAS score ≥3 at discharge， compared to 2 （18.2%） patients in the TES group， with a statistically significant difference（P＜0.001）.Postoperative SF-36 scores indicated significant quality-of-life improvements in both groups，but with no statistically significant difference between groups （P＞0.05）.

Conclusion

Both TES and IPOM surgeries exhibit good effect for umbilical hernias and enhance the short-term postoperative quality of life in patients.TES offers benefits in reducing postoperative pain and lowering hospitalization costs.