经腹腹膜前疝修补术与Lichtenstein术治疗老年嵌顿性腹股沟疝的临床疗效对比

Clinical comparison of Trans-abdominal preperitoneal laparoscopic approach and Lichtenstein hernia repair for the elderly incarcerated inguinal hernia

目的对比评价经腹腹膜前疝修补术(TAPP)与Lichtenstein无张力疝修补术治疗老年嵌顿性腹股沟疝的临床疗效。方法回顾性分析2015年1月至2018年1月天津市人民医院和天津市第三中心医院收治的95例老年嵌顿性腹股沟疝患者,依据手术方式不同分为腹腔镜组(TAPP)和开放组(Lichtenstein),对比2组患者一般资料、手术时间、住院时间、首次通便时间、术后并发症发生率及复发率等指标。结果腹腔镜组患者平均手术时间(65.45±9.72)min,平均住院时间(6.86±1.12)d,首次通便时间平均(2.60±0.70)d。开放组患者平均手术时间(63.13±11.05)min,平均住院时间(7.52±1.36)d,首次通便时间平均(2.80±1.03)d,2组患者手术时间、住院时间及首次通便时间差异均无统计学意义(P>0.05)。腹腔镜组患者术后并发症发生率及复发率明显低于开放组(P<0.05)。结论腹腔镜手术治疗老年嵌顿性腹股沟疝更加安全有效,在满足手术适应证条件下,应首选腹腔镜手术治疗。

Objective To compare and evaluate the clinical efficacy of Trans-abdominal preperitoneal(TAPP)and Lichtenstein hernia repair in the treatment of elderly incarcerated inguinal hernia.Methods A retrospective analysis of 95 elderly patients with incarcerated inguinal hernia in Tianjin Union Medical Center and Tianjin third Hospital from January 2015 to January 2018 was performed.Patients were divided into laparoscopic group(TAPP)and open group(Lichtenstein hernia repair)according to different surgical methods.The general clinical data,operation time,hospital stay,first laxative time,postoperative complication rate and recurrence rate of the two groups were compared.Results The average operative time of the laparoscopic group was(65.45±9.72)min,the average hospital stay was(6.86±1.12)d,and the average first laxative time was(2.60±0.70)d.The average operation time of the open group was(63.13±11.05)min,the average hospital stay was(7.52±1.36)d,and the average first laxative time was(2.80±1.03)d.There was no significant difference in operation time,hospital stay and first laxative time between the two groups(P>0.05).The overall complication rate and recurrence rate of patients in the laparoscopic group were significantly lower than those in the open group(P<0.05).Conclusion Laparoscopic surgery is safer and more effective for the treatment of elderly incarcerated inguinal hernia.Under the conditions of surgical indications,laparoscopic surgery should be preferred.