腹腔镜全腹膜外疝修补术与经腹腹膜前疝修补术治疗腹股沟疝患者的效果比较

Comparison of effects of laparoscopic total extraperitoneal repair and transperitoneal preperitoneal repair in treatment of inguinal hernia

目的:比较腹腔镜全腹膜外疝修补术(TEP)与经腹腹膜前疝修补术(TAPP)治疗腹股沟疝患者的效果。方法:选取2019年2月至2021年2月该院收治的116例腹股沟疝患者进行前瞻性研究,按照随机数字表法将其分为对照组与观察组各58例。对照组行TAPP治疗,观察组行TEP治疗,术后随访3个月。比较两组手术相关指标(术中出血量、手术时间、住院时间与住院费用)水平、术后1 d疼痛程度[视觉模拟评分法(VAS)]评分、炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]水平、手术前后生命质量[生活质量综合评定问卷(GQOLI-74)]评分、并发症发生率和随访3个月时的复发率。结果:观察组手术时间短于对照组,住院费用少于对照组,差异有统计学意义(P<0.05);术后3个月,观察组心理功能、躯体功能、社会功能、物质生活等GQOLI-74维度评分均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为5.17%(3/58),低于对照组的17.24%(10/58),差异有统计学意义(P<0.05);两组术中出血量、住院时间、术后1 d VAS评分、CRP水平、TNF-α水平及复发率比较,差异均无统计学意义(P>0.05)。结论:与TAPP比较,TEP治疗腹股沟疝患者可缩短手术时间,减少住院费用,提高生命质量,降低术后并发症发生率,但术中出血量、住院时间、术后1 d VAS评分、炎性因子水平及复发率与TAPP相当。

Objective:To compare effects of laparoscopic total extraperitoneal repair(TEP)and transabdominal preperitoneal repair(TAPP)in treatment of inguinal hernia.Methods:A prospective study was conducted on 116 patients with inguinal hernia admitted to the hospital from February 2019 to February 2021.They were divided into control group and observation group according to the random number table method,58 cases in each.The control group was treated with TAPP,while the observation group was treated with TEP.These patients were followed up for 3 months.The operation related index levels(intraoperative blood loss,operation time,hospitalization time and hospitalization cost),the pain degree[visual analogue scale(VAS)]score 1 day after the operation,the inflammatory factor levels[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)],the quality of life[general quality of life inventory(GQOLI-74)]scores before and after the operation,the incidence of complications,and the recurrence rate at 3 months of follow-up were compared between the two groups.Results:The operation time of the observation group was shorter than that of the control group,the hospitalization cost was less than that of the control group,and the differences were statistically significant(P<0.05).3 months after the operation,the scores of GQOLI-74 dimensions such as psychological function,physical function,social function and material life in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The incidence of complications of the observation group was 5.17%(3/58),which was lower than 17.24%(10/58)in the control group,and the difference was statistically significant(P<0.05).However,there were no significant differences in the intraoperative blood loss,the hospitalization time,the VAS score,the CRP level,the TNF-αlevel and the recurrence rate between the two groups(P>0.05).Conclusions:Compared with TAPP,TEP can shorten the operation time,reduce the hospitalization cost,improve the quality of life and reduce the incidence of postoperative complications in the patients with inguinal hernia.The intraoperative blood loss,the hospitalization time,the postoperative pain score,the inflammatory factor levels and the recurrence rate are comparable to TAPP.