3种开放式无张力疝修补术治疗成人腹股沟疝的比较

Clinical controlled study of three kinds of open tension-free hernia repair in treatment of adult inguinal hernia

收集经无张力疝修补术治疗并获得随访的腹股沟疝患者786例,其中行李金斯坦(Lichtenstein)378例,疝环充填式(Rutkow)322例,开放TEP 86例。比较3种手术方式的手术时间、术后住院时间、术后恢复时间、住院费用、术后并发症等,记录相关数据进行统计学分析。结果显示:3组患者的手术时间、平均住院时间、术后恢复时间、治疗费用差异均无统计学意义,而术后并发症腹股沟区疼痛差异有统计学意义(P<0.05),开放TEP组明显少于另外两组,Lichtenstein组最高。开放TEP组切口感染、神经感觉异常、阴囊水肿情况明显少于另外两组(P<0.05),而Lichtenstein组与Rutkow组比较,差异无统计学意义。但7例血清肿发生于开放TEP术后,较另外两组发生率高,差异有统计学意义(P<0.05)。Lichtenstein、Rutkow、开放TEP 3种无张力疝修补术治疗成人腹股沟疝各有优势,可根据具体情况,权衡利弊,择优取之。

786-followed up cases of inguinal hernia were collected, including Lichtenstein 378 cases, 322 cases of Rutkow, 86 cases of routine open TEP. Three surgical methods in operative time, the postoperative hospital stay, the postoperative recovery time, the hospital cost,and the postoperative complications were compared and analyzed. The results showed that there was no significant difference in the operative time, the average length of hospital stay, postoperative recovery time,and the cost of treatment in three groups of patients. Groin pain in postoperative com-plications among the three groups was different （ P＆lt;0 . 05 ） . Open TEP group was significantly less than the other two groups, and Lichtenstein group was the highest. Wound infection, nerve paresthesia, scrotal edema in the open TEP group were significantly less than the other two groups （ P＆lt;0.05 ） . But seven seroma cases occurred in TEP group, was higher than the other two groups, and the difference was statistically significant （ P ＆lt;0.05 ） . Three kinds of open tension-free hernia repair inguinal hernia treatments of adults had their own advantages, according to the specific circumstances, weighing the pros and cons to merit it.