两种腹腔镜下疝修补术治疗腹股沟疝的疗效比较

Comparison on therapeutic effect of two kinds of laparoscopy hernia repair in treatment of inguinal hernia

目的探讨两种腹腔镜下疝修补术治疗腹股沟疝的临床效果。方法选择本院2008年5月至2011年3月行腹腔镜腹股沟疝修补术的患者85例,将患者随机分为两组:经腹腹膜前疝修补术(TAPP)组(53例)和腹腔镜全腹膜外疝修补术(TEP)组(32例)。观察两组患者手术情况及住院时间、术后恢复情况及并发症发生情况等指标。结果两组手术均获成功,无中转开放。TAPP组与TEP组患者在手术时间、术中出血量、平均住院时间、术后住院时间方面无明显差异(P>0.05),在手术费用上TAPP组高于TEP组,具有统计学差异(P<0.05)。TAPP组与TEP组患者在术后1～5天最高体温、肛门排气时间、镇痛药使用率方面无明显差异(P>0.05)。TAPP组1例患者术后出现暂时的腹股沟区神经感觉异常,1例患者出现肠梗阻,经保守治疗后缓解。TEP组1例患者出现腹壁皮下血清肿。TAPP组并发症发生率为3.8%(2/53),TEP组并发症发生率为3.1%(1/32),两组患者在并发症发生率方面无统计学差异(P>0.05)。全部患者术后均获得全程随访,两组患者均无复发。结论TAPP与TEP均是治疗腹疝安全、有效的手术方式,值得临床推广应用。

Objective To investigate the efficacy and the clinical application value of two different kinds of laparoscopy hernia repair in treat ment of inguinal hernia.Methods From May 2008 to March 2011,the clinical data of 85 cases of inguinal hernia treated in our hospital were analyzed retrospectively.53 cases underwent transabdominal preperitoneal prosthesis（TAPP） and 32 cases underwent totally extraperitoneal prosthesis（TEP）.Results The operations of the two groups were all successful and there was no conversion to open operation.Compared with the TAPP group,the operation time,the blood loss,the time of vascular control in TEP group had no significant difference（P0.05）.Compared with the TAPP group,the average hospital stay and the postoperative hospital stay in TEP group had no significant difference（P0.05）.Compared with the TAPP group,the postoperative temperature and the intestinal restored time in TEP group had no significant difference（P0.05）. Conclusion TAPP and TEP were two kinds of safety and effectively methods for the treatment of abdominal hernia.