单中心腹腔镜与传统开放切口疝修补术的临床对比研究

The clinical comparative study of single-institution laparoscopes versus open incisional hernia repairs

目的探讨单中心腹腔镜与传统开放切口疝修补术在住院时间、复发率等临床指标的差异。方法对2009年10月至2012年6月98例切口疝患者进行前瞻性单中心队列研究,患者行腹腔镜腹膜内置网修补法或开腹肌鞘前网片修补术。随机分为腹腔镜组(观察组)52例,开放组(对照组)46例。对二组患者的手术时间、住院时间、住院费用及严重并发症进行了分析与比较。结果观察组平均手术时间(80±14)min,对照组平均手术时间(110±56)min,二组差异有统计学意义(P=0.000)。观察组平均术后住院时间(5.9±0.8)d,明显少于对照组(11.3±4.6)d,差异有统计学意义(P=0.000)。观察组复发3例(3/52),对照组复发1例(1/46)。结论腹腔镜腹腔内补网片手术优于开放式网状修复,出血少、损失小、并发症少、住院时间短、良好的美容效果,但住院费用较高。

Objective To investigate the difference in recurrence rate, and the length of hospitalization stay in patients with open or laparoscopic incisional hernia repair （LIHR）. Methods A total of 98 patients diagnosed with incisional hernias from October 2009 to June 2012 were retrospectively analyzed. All patients were randomized into observation group （ n = 52） and control group （ n = 46 ）. The observation group were treated with laparoscopic, the control group were treated with open repairs. The operation time, durations of hospitalization stay, the Hospitalization expensesand significant complications were analyzed and compared. Results There were significant difference between two groups with operative time （P = 0.000）. Mean hospitalization stay in the group with open repair was 11.3 days and 5.9 days in the group with laparoscopic repair. The hospitalization stays were shorter in the LIHR group （P = 0.000）. There were 3/52 cases of recurrence in the group with laparoscopic repair and 1/46 case Of recurrence in the group with open repair. Conclusions LIHR is superior to open mesh repair in terms of less bleeding, fewer complications, shorter hospitalization stays, and acceptable appearances, while the cost of hospitalization is more expensive.