开放腹膜前无张力疝修补术与前入路治疗腹股沟复发疝的对比研究

Open preperitoneal approach and anterior approach in tension-free repair of recurrent inguinal hernia

目的比较经下腹正中切口后入路腹膜前无张力疝修补术与原切口前入路治疗腹股沟复发疝中的疗效。方法自2007年1月至2010年6月,将60例经腹股沟前入路修补术后腹股沟首次复发疝患者随机分为研究组和对照组。研究组接受经下腹正中切口开放腹膜前无张力疝修补术,对照组接受经原切口入路治疗。比较两组的手术时间、住院时间、恢复正常工作时间、疼痛评分、手术并发症及复发率。结果研究组平均随访时间23.6个月,对照组平均随访时间22.9个月。住院时间、恢复正常工作时间、疼痛评分、复发方面两组间无差异(P>0.05)。研究组的手术时间更短,并发症发生率更低,两组间差异具有统计学意义(P<0.05)。结论经下腹正中切口开放腹膜前无张力疝修补术具备安全可行、手术时间短、并发症低的优势,是治疗腹股沟复发疝的理想方法。

Objective To compare the clinical effect of open preperitoneal approach tension- free her- nia repair via hypogastric middle-line incision with anterior approach tension- free hernia repair in the treatment of recurrent inguinal hernia. Methods 60 eases with recurrent inguinal hernia were allocated randomly to open preperitoneal approach group （30 cases） and anterior approach group （30 eases）. Operati on time, hospital stay, time for returning to work, visual analogue score （VAS） , operative complications and recurrence rate were compared between these two groups. Results Average follow-up time was 23.6 months in the open preperito- heal approach group and 22. 9 months in the anterior approach group. There was no significant difference in hos- pital stay, time for returning to work, visual analogue score （VAS） between the open preperitoneal approach group and the anterior approach group （P 〉 0.05 ）. Shorter operation time and reduced complication rate were found in the open preperitoneal approach group（P 〈 0. 05）. Conclusion Open preperitoneal approach via hy- pogastric middle-line incision in tension-free repair of recurrent inguinal hernia is a satisfactory procedure with the advantage of reducing the operation time, lowering the incidence of operative complications.