腹腔镜完全腹膜外腹股沟疝修补术与Lichtenstein修补术的比较

Comparison of total extraperitoneal laparoscopic inguinal hernia repair and Lichtenstein repair

目的对比腹腔镜完全腹膜外腹股沟疝修补术与Lichtenstein修补术的临床疗效。方法选择2008年4月至2009年5月245例腹股沟疝患者,随机分成两组,TEP组行腹腔镜全腹膜外腹股沟疝修补术,Lichtenstein组行Lichtenstein修补术。对比两组患者手术时间、平均住院时间、住院费用、平均恢复正常活动时间以及近远期并发症等指标,评价两种手术方式的疗效。结果 TEP组行单侧疝修补术的手术时间长,平均住院费用高,术中中转手术方式比例高,但恢复正常活动时间短,术后近远期并发症少。结论尽管TEP术存在手术时间长、住院费用高、术中中转手术概率高等缺点,但术后疼痛少,恢复正常活动时间短,对于有经验的外科医生应作为首选术式。

Objective To compare the clinical effect between total extraperitoneal laparoscopic inguinal hernia repair and Lichtenstein repair. Methods Two hundred and forty-five patients with inguinal hernia from April 2008 to May 2009 were randomly divided into Group TEP and Group Lichtenstein. Operating time, hospital stay, medical costs, recovery of daily life, short and long-term complications were compared between two groups. Results Mean operating time for a unilateral hernia with TEP was longer, medical costs and the proportion of operating conversions were higher. However, patients had a faster recovery of daily activities and less short and long-term complications after TEP. Conclusions TEP procedure is associated with longer mean operating time, higher medical cost and the proportion ofoperating conversions but less postoperative pain and faster recovery of daily activities. TEP is recommended in experienced hands.