脱细胞基质补片和聚丙烯补片在腹腔镜腹股沟疝修补术后复发的对比研究

A comparative study of the recurrence of acellular matrix mesh and polypropylene mesh after laparoscopic inguinal hernia repair

目的探讨脱细胞基质补片和聚丙烯补片在腹腔镜经腹腹膜前腹股沟疝修补(TAPP)术后复发率差异及原因。方法回顾性分析济南市中心医院自2015年12月至2022年6月共992例(1147侧)TAPP患者的临床资料,按照使用补片类型分为脱细胞基质补片组和聚丙烯补片组。对照分析脱细胞基质补片(495侧)与聚丙烯补片(652侧)术后复发的差异。结果两组的性别、年龄、疝分类等差异无统计学意义(P<0.05)。两组的随访时间、手术时间、术后住院时间差异无统计学意义(P<0.05)。在TAPP术中使用脱细胞基质补片复发率高于聚丙烯补片(5/495 vs 1/652,P=0.047)。结论TAPP术中应用脱细胞基质补片较应用聚丙烯补片复发率高,复发因素与补片是否有效固定、补片自身特性等相关。但整体复发率不高,是安全有效的。

Objective To investigate the difference in recurrence rate between acellular matrix mesh and polypropylene mesh after laparoscopic transabdominal preperitoneal inguinal hernia repair(TAPP)and its causes.Methods The clinical data of 992 patients(1147 sides)with TAPP in Jinan Central Hospital from December 2015 to June 2022 were retrospectively analyzed.According to the type of patch used,the patients were divided into an acellular matrix patch group and a polypropylene patch group.The difference of postoperative recurrence between acellular matrix mesh(495 sides)and polypropylene mesh(652 sides)was compared and analyzed.Results There was no significant difference in gender,age,or hernia classification between the two groups(P<0.05).There were no significant differences in follow-up time,operation time,or postoperative hospital stay between the two groups(P<0.05).The recurrence rate of the acellular matrix patch was higher than that of the polypropylene patch(5/495 vs 1/652,P=0.047).Conclusion The recurrence rate of the acellular matrix patch is higher than that of the polypropylene patch in TAPP.The recurrence factors are related to the effective fixation of the patch and the characteristics of the patch.However,the overall recurrence rate is not high,so it is safe and effective.