经腹腔腹膜前与完全腹膜外腹腔镜腹股沟疝修补术119例对比分析

Comparative analysis of 119 cases transabdominal preperitoneal and total extraperitoneal laparoscopic inguinal hernia repair patients

目的比较经腹腔腹膜前与完全腹膜外腹腔镜腹股沟疝修补2种手术途径的有效性和安全性。方法 2005年8月至2008年8月期间,本院腹腔镜中心行腹腔镜腹股沟疝修补术的患者随机分为两组,行经腹腔腹膜前腹腔镜疝修补术(TAPP)组55例,行完全腹膜外腹腔镜疝修补术(TEP)64例,将TAPP组和TEP组的临床资料进行比较分析。结果术后随访6个月到3年;TEP组手术时间较短(P=0.000),费用较低(P=0.035),术中出血量和术后住院时间无显著差别;腹膜前损伤、血肿、血清肿、肠梗阻、尿潴留、肠道损伤、术后6周疼痛、感染和复发的比率均无显著差别。结论 TAPP与TEP各具优点,但与TAPP比较,TEP手术时间较短,费用较低;两者适应证的选择没有差别。

Objective To compare the efficacy and safety between transabdominal preperitoneal and total extraperitoneal laparo scopic inguinal hernia repair. Methods From August 2005 to August 2008,in our laparoscopic surgery center,the patients who had underwent laparoscopic inguinal hernia repair were randomly divided into two groups according to surgical method, via transabdomi- nal preperitoneat laparoscopic hernia repair （TAPP） group of 55 patients, via totally extraperitoneal laparoscopie hernia repair （TEP） group of 64 cases,make a comparative analysis of clinical data between TAPP group and TEP group. Results Patients were followed up from 6 months to 3 years ;TEP operative time was shorter （P=0. 000）,lower costs （P=0. 035）, blood loss and post- operative hospital stay has no significant difference; preperitoneal injury,hematoma, serum swelling,intestinal obstruction, urinary retention,intestinal injury,after 6 weeks for pain,infection and recurrence rates were not significantly different. Conclusion TAPP with TEP each have advantages,but with the TAPP comparison,TEP operation time was shorter in lower costs. There is no differ- ence between the selection of indications.