开展腹腔镜腹股沟疝修补术初期的术式选择

Study on the approach to Laparoscopy inguinal hernia repair for groin hernias at initial stage

目的探讨开展腹腔镜腹股沟疝修补术初期如何选择合适的手术方式。方法回顾性分析2008年1月至2010年6月,我院最初行腹腔镜腹股沟疝修补术的42例患者的临床资料,其中经腹腹膜前补片植入术(TAPP)28例,全腹膜外补片植入术(TEP)14例,随访时间6～24个月(中位时间l5个月)。结果 14例TEP中8例完成,6例中转为开放TEP手术,28例TAPP全部顺利完成手术。TAPP组术后并发症发生率高于TEP组,但两组差异无统计学意义,手术时间及中转率TEP均高于TAPP组,差异有统计学意义(P<0.05)。随访期内TEP和TAPP均无复发。结论对于初期开展腹腔镜腹股沟疝修补术的初学者应该首先从熟练完成TAPP术式开始。在熟练掌握TAPP之后再过度到TEP术式才是是安全的,外科医师的临床经验比术式选择更为重要。

Objectve To study the approach of how to choose suitable modus operandi in laparoscopic inguinal hernia repair at initial stage. Methods Retrospective analysis of 42 patients who underwent Iaparoseopic inguinal hernia repair from Jan 2008 to Jun 2010. Results Followed - up time from 6 to 24 months. Eight eases had been perfbrmd TEP, six cases were converted to open approach TEP, and 28 cases had been pertbmmd TAPP. There were significant ditbrences between TAPP and TEP when considering operation time or transterenee rate （P 〈 0.05）.. Conclusions To carry out laparoseopie inguinal hernia at initial stage should firstly skilled handling TAPP operation. The surgeong clinical experience was more important than the choice of approach to laparoscopie repair for inguinal hernia.