腹腔镜与腹股沟切口行无张力疝修补术的疗效对比

Outcome of Laparoscopic and Open Tension-Free Inguinal Hernia Repair

目的评价腹腔镜与腹股沟切口行无张力疝修补术的疗效,并且分别探讨其临床应用价值。方法共有66例腹股沟疝患者接受手术治疗,其中腹股沟直疝48例,斜疝14例,双侧腹股沟疝4例。23例患者行腹腔镜疝修补术治疗;43例患者行疝环充填式无张力疝修补术。对比2种术式的各项临床指标,如手术时间、术后疼痛持续时间、术后并发症发生率、住院时间,以及复发率等,总结其临床应用价值。结果腹腔镜组的手术时间较长,但其他指标与常规的疝环充填式无张力疝修补术基本相同,甚至更为优越。所有患者均成功实施疝修补术,出院后随访1年内未见有复发病例。结论疝环充填式无张力疝修补术,对患者的损伤较轻,且操作简便,临床复发率低。而腹腔镜疝修补术在某种程度上更为优越,患者的术后并发症和疼痛情况更少,恢复更快,是临床治疗腹股沟疝的另一种理想手段。

Objective To compare the outcome of laparoscoplc and open tenslon-free inguinal hernia repair. Methods There were 66 patients receiving inguinal hernia repairs and 48 cases with direct hernia, 14 cases with indirect hernia and 4 cases with bilateral inguinal hernia. Laparoscopic inguinal hernia repair was performed to 23 patients and Lichtenstein＇s tension-free hernia repair was performed to the other 43 patients. The clinical indexes of these two techniques were compared, including mean operative time, mean pain scores, postoperative complications, stay in hospital, and recurrence rate. Results The mean operative time in the laparoscopic group was longer than that in the open group. But the other indexes in the laparoscopic group were as same as, or even better than those in the open group. All the hernia repairs were successful and no major complications appeared in either group. During the follow-up period of 1 year, no recurrence was found in these patients. Conclusions The open anterior tension-free inguinal hernia repair is a safe operation with high success rate and fewer invasions. In terms of complications and pain in the postoperative patients, laparoscopic technique is better than the open repair, which led to earlier ambulation. So laparoscopic inguinal hernia repair is an ideal alternative for clinical application.