腹股沟疝前入路与后入路无张力疝修补术疗效比较

Comparison of effectiveness between the inguinal tension-free herniorraphy through the anterior approach and posterior approach

目的比较腹股沟疝前入路与后入路无张力疝修补术的修补效果与并发症。方法选取我院2001年1月至2007年5月腹股沟疝病例375例,年龄介于21～87岁,全部为男性,分为两组,其中经前入路进行平片无张力修补术203例,为A组;经后入路进行巨大补片加强腹膜囊手术172例,为B组。随访时间为(3±0.8)年。结果在NyhusⅠ、NyhusⅡ、NyhusⅢA型腹股沟疝无张力修补术中后入路与前入路在手术并发症即修补效果上没有差别;在NyhusⅢB、NyhusⅣA、NyhusⅣB型腹股沟疝无张力修补术中,前入路腹股沟疼痛及神经痛发生率高,与后入路比较有统计学意义,后入路手术血清肿发生率高,有统计学意义,两组修补效果没有统计学上的差别。结论后入路腹股沟疝无张力修补术修补效果与前入路手术无差别,术后并发症各有特点,但后入路组术后患者更舒适。

Objective To discuss the effectiveness and complication of inguinal tension-free herniorrhaphy through the anterior approach and the posterior approach.Methods 361 male inguinal cases from January of 2001 to May of 2007,aged 21 to 87 years old,had been divided into 2 groups.The A group had 203 cases,with the Lichtenstein operations through the anterior approach;the B group had 172 cases,with the Stoppa operations though the posterior approach.The fellow-up time were 3±0.8 years.Results There had no difference in effectiveness and complication of the types of NyhusⅠ,Nyhus Ⅱand Nyhus ⅢA.The anterior approach operations had more groin pain and neuralgia in the types of Nyhus ⅢB,Nyhus ⅣA,Nyhus ⅣB,which had statistical significance accorded to the posterior approach,and the posterior approach operations had more seroma in the types of Nyhus ⅢB,Nyhus ⅣA,Nyhus ⅣB,which had statically significance accorded to the anterior approach.There had no difference in the operation effect.Conclusion The posterior approach tension-free herniorrhaphy has no difference in the operation effect according to the anterior approach,and the 2 groups have different complication after operation,but the posterior approach group is more comfortable after operation.