疝环充填或改良Kugel术治疗腹股沟疝的回顾性对比研究

Comparison of two tension-free repair techniques (modified Kugel and Plug-Mesh procedures) for inguinal hernias

目的:回顾性比较疝环充填术与前入路改良Kugel腹膜前疝修补术治疗腹股沟疝在时间、住院时间、恢复工作时间、手术并发症及复发率等方面,评价两种术式的疗效及优缺点。方法:采用回顾性非随机对照方法,将2003年7月至2009年7月期间的987例1 065侧腹股沟疝病人(其中78例为双侧)分为疝环充填修补组(网塞组,521侧)和改良Kugel修补组(MK组,544侧)。网塞组采用BARD公司的Plug-Mesh进行无张力修补,MK组采用BARD公司的Modified Kugel(MK)补片修补。结果:平均随访时间3～40(20.0±5.3)个月。两组病人的平均手术时间、住院时间、手术并发症和术后复发率差异圴无统计学意义。MK组术后腹股沟区疼痛不适的发生率显著低于网塞组(P<0.05)。结论:与临床广泛采用的疝环充填式无张力疝修补术相比,前入路改良Kugel腹膜前疝修补术同样操作简单,疗效可靠,同时可显著降低术后病人疼痛不适的发生率,具有较好的临床应用价值。

Objective This retrospective comparison study is undertaken to evaluate the effect of two tension-free procedures for inguinal hernia repair.Methods In a prospective non-randomized controlled study basing upon 987 patients with 1 065 hernias（78 cases with bilateral hernias） admitted between July 2003 and July 2009,were allocated non-randomly to the Plug-Mesh group（521 cases） or the Modified Kugel group（MK group）（544 cases）.The operation time,hospital stay,time for returning to normal life or work,operative complications and recurrence rate were compared between two groups.Results The follow-up period ranged from 3 to 40 months（mean 20±5.3 months）.No significant differences were found between the two groups in the operation time,hospital stay,operative complications and recurrent rate,but the occurrence of postoperative groin pain was significantly lower in the MK group（P0.05）.Conclusions Preperitoneal hernia repair with the modified Kugel mesh via the anterior approach is an effective tension-free procedure for inguinal hernia,resulting in less postoperative pain in the groin area.