单孔与多孔法腹腔镜手术治疗腹股沟疝的回顾性对比研究

Retrospective study on transumbilical single-incision laparoscopic versus conventional laparoscopic surgery for inguinal hernia repair

目的探讨单孔腹腔镜腹股沟疝修补术的安全性和可行性。方法 2009年12月至2011年3月行单孔腹腔镜腹股沟疝修补术11例(单孔组),其中直疝2例,斜疝9例。10例行单孔腹腔镜完全腹膜外疝修补术(TEP),1例行经腹腔腹膜前修补术(TAPP)。同期多孔法腹腔镜手术患者18例(多孔组),其中直疝5例,斜疝13例。16例行TEP,2例行TAPP。收集两组患者围手术期资料进行比较分析。结果两组在术中出血量(P=0.579)和术后住院时间(P=0.839)方面比较差异无统计学意义。在手术时间方面,单孔组长于多孔组(P=0.016),差异有统计学意义。术后随访3～18个月,两组术中、术后并发症比较差异无统计学意义。结论单孔腹腔镜腹股沟疝修补术安全、有效,具有可行性。其临床应用价值仍需进一步的临床研究证实。

Objective To study the clinical data of patients who underwent transumbilical single-incision laparoscopic and conventional laparoscopic inguinal hernia repair and explore the safety and feasibility of transumbilical single-incision laparoscopic inguinal hernia repair.Methods From Dec 2009 to Mar 2011,11 patients underwent transumbilical single-incision laparoscopic inguinal hernia repair.There were 2 patients with direct inguinal hernia and 9 with indirect inguinal hernia,while 10 of whom underwent totally extraperitoneal laparoscopic hernia repair（TEP） and 1 transabdominal preperitoneal laparoscopic hernia repair（TAPP）.Eighteen patients underwent conventional laparoscopic inguinal hernia repair.There were 5 patients with direct inguinal hernia and 13 with indirect inguinal hernia,while 16 of whom underwent TEP and 2 TAPP.Results Blood loss（P = 0.579）and postoperative hospital stay（P = 0.839） had no significant difference.The operative time was shorter in conventional laparoscopic group which was significantly different（P = 0.016）.The postoperative complications between the two groups had no significant difference after a period of 3 to 18 months.Conclusions Transumbilical single-incision laparoscopic inguinal hernia repair is safe and feasible while its clinical application needs further study.