经腹腹膜前疝修补术治疗前列腺根治性切除术后并发腹股沟疝疗效分析

Clinical analysis of transabdominal preperitoneal hernia repair in the treatment of inguinal hernia after radical prostatectomy

目的探讨腹腔镜经腹腹膜前疝修补术(TAPP)治疗前列腺根治性切除术后并发腹股沟疝的临床疗效,为优化前列腺根治性切除术后腹股沟疝患者的手术治疗提供理论依据。方法回顾性研究2016年1月至2020年12月,在上海交通大学医学院附属第九人民医院接受TAPP治疗的前列腺根治性切除术后并发腹股沟疝患者68例和原发性腹股沟疝患者215例,按照腹股沟疝形成原因进行分组,前列腺根治性切除术后并发腹股沟疝患者为试验组,原发性腹股沟疝患者为对照组,分析并比较2组患者的手术相关指标(手术时间、术中出血量、术后住院天数)、术中并发症发生率、术后24 h疼痛评分、术后并发症发生率及术后复发情况。结果试验组手术时间较对照组长(P<0.05)。2组患者的术中出血量、术中并发症发生率、术后住院天数、术后疼痛评分、术后并发症发生率及术后复发情况比较,差异均无统计学意义(P>0.05)。结论前列腺根治性切除术后并发腹股沟疝行TAPP治疗安全有效,与原发性腹股沟疝患者疗效相似。

Objective To explore the clinical effect of laparoscopic transabdominal preperitoneal repair(TAPP)in the treatment of inguinal hernia after radical prostatectomy,and to provide theoretical basis for optimizing the surgical treatment of inguinal hernia after radical prostatectomy.Methods A retrospective study was conducted on 68 patients with inguinal hernia and 215 patients with primary inguinal hernia after radical prostatectomy treated by TAPP in the Shanghai Ninth People's Hospital,School of Medicine,Shanghai Jiao Tong University from January 2016 to December 2020.According to the causes of inguinal hernia,the patients with inguinal hernia after radical prostatectomy were the experimental group,and the patients with primary inguinal hernia were the control group.The operation time,intraoperative blood loss,intraoperative complication rate,postoperative hospital stay,postoperative pain score,postoperative complication rate and postoperative recurrence of the two groups were analyzed and compared.Results The surgical time of the experimental group was longer than that of the control group(P<0.05).There was no statistically significant difference(P>0.05)between the two groups of patients in terms of intraoperative bleeding volume,incidence of intraoperative complications,postoperative hospitalization days,postoperative pain score,incidence of postoperative complications,and postoperative recurrence.Conclusion TAPP is safe and effective in the treatment of inguinal hernia after radical prostatectomy.The efficacy of laparoscopic repair for inguinal hernia after radical prostatectomy is similar to that of patients with primary inguinal hernia.