腹腔镜完全腹膜外疝修补术治疗腹壁切口疝的临床疗效

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

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.