腹膜外腔镜无张力疝修补术治疗腹股沟疝的临床效果分析

Clinical Effect Analysis of Laparoscopic Totally Extraperitoneal Prosthesis for Inguinal Hernia

目的探讨腹膜外腔镜无张力疝修补术治疗腹股沟疝的临床效果及安全性。方法选取2019年3月—2021年3月于无锡市第八人民医院普外科行腹腔镜手术治疗的腹股沟疝患者60例为研究对象,以双色球的形式将其随机分为观察组和对照组,每组30例。对照组行腹腔镜腹膜前腹股沟疝补片修补术(TAPP),观察组行腹腔镜全腹膜外腹股沟疝修补术(TEP),比较两组的治疗效果。结果观察组的术后首次下床活动时间、胃肠功能恢复时间及住院时间均短于对照组,组间差异有统计学意义(P<0.05)。两组术后1 d的各项应激指标水平均高于术前,但观察组各指标水平均低于对照组,组间差异有统计学意义(P<0.05)。观察组的并发症发生率及复发率分别为13.33%、0.00%,与对照组的20.00%、3.33%比较,组间差异无统计学意义(P>0.05)。结论腹股沟疝采用TEP和TAPP治疗均可获得良好的效果,但TEP术后恢复优势更为突出,短期内患者的应激反应小,可根据实际情况选择合适的手术方式。

Objective To investigate the clinical effect and safety of laparoscopic totally extraperitoneal prosthesis for inguinal hernia.Methods 60 patients with inguinal hernia treated by laparoscopic surgery in Wuxi Eighth People’s Hospital from March 2019 to March 2021 were selected as the research objects,and they were randomly divided into an observation group and a control group in the form of dichromatic spheres,with 30 patients in each group.The control group received laparoscopic transabdominal preperitoneal(TAPP),and the observation group received laparoscopic totally extraperitoneal prosthesis(TEP).The therapeutic effects of the two groups were compared.Results The time of first postoperative ambulation,recovery time of gastrointestinal function and hospital stay in the observation group were shorter than those in the control group,and the differences between the groups were statistically significant(P<0.05).The stress indexes of both groups1 day after surgery were higher than those before surgery,but the indexes of the observation group were lower than those of the control group,and the differences between the groups were statistically significant(P<0.05).The complication rate and recurrence rate in the observation group were 13.33%and 0.00%,respectively,compared with 20.00%and 3.33%in the control group,there were no statistical significances(P>0.05).Conclusion The treatment of inguinal hernia by TEP and TAPP can achieve good results,but the postoperative recovery advantage of TEP is more prominent,the short-term stress response of patients is small,and the appropriate surgical method can be selected according to the actual situation.