内环口定型在腹腔镜完全腹膜外疝修补术中的应用体会

Application of repairing the inguinal ring during laparoscopic totally extraperitoneal prosthesis

目的:探讨内环口定型在腹腔镜完全腹膜外疝修补术(totally extraperitoneal,TEP)中的安全性、有效性,总结TEP开展初期降低术后复发率的方法。方法:回顾分析2009年9月至2013年6月为100例患者行TEP的临床资料,将其分为两组,50例行常规TEP,50例行内环口修补定型加TEP,观察两组手术时间、住院时间、术后第2天疼痛评分、复发及其他术后并发症等情况。结果:两组手术均顺利完成。两组患者术后第2天疼痛分数、复发率、手术时间差异有统计学意义(P<0.05),住院时间及其他术后并发症差异无统计学意义(P>0.05)。结论:腹腔镜完全腹膜外疝修补术中行内环口修补定型安全、可靠,可提高手术疗效。尤其TEP开展初期,内环口修补定型可防止疝复发。

Objective： To investigate the safety and efficacy of repairing the inguinal ring during laparoscopic totally extraperitoneal prosthesis（ TEP）,and to research how to reduce the postoperative hernia recurrence in the beginning of carrying out TEP. Methods： The clinical data of 100 patients who underwent laparoscopic TEP from Sep. 2009 to Jun. 2013 were retrospectively analyzed. The patients were classified into two groups： the repairing the inguinal ring during TEP group with 50 cases and the TEP group with 50 cases. The primary endpoints were operative time,hospital stay,postoperative pain on the second day,the recurrence and postoperative complications. Results： The operation was successfully performed in 100 patients. No significant difference was found between the two groups in hospital stay and postoperative complications（ expect the recurrence rate）,except for the mean operative time,postoperative pain on the second day and the recurrence rate（ P 0. 05）. Conclusions： Repairing the inguinal ring during laparoscopic TEP is safe and reliable,improves operative effect and prevents recurrence in the beginning of laparoscopic TEP.