完全腹膜外疝修补术与李金斯坦修补术治疗成人腹股沟疝的对比研究

Comparative study of total extraperitoneal laparoscopic repair and Lichtenstein repair in adult inguinal hernia

目的比较完全腹膜外疝修补术（TEP）与李金斯坦修补术（Lichtenstein）治疗成人腹股沟疝的临床效果。方法回顾性分析2012年1月至2013年10月，华润武钢总医院收治成人腹股沟疝220例手术治疗的临床资料，其中102例行TEP（观察组），118例行开放式Lichtenstein修补术（对照组），对比二组手术时间，术后住院时间，并发症发生率，术后疼痛评分，住院费用及复发情况。结果观察组较对照组住院时间明显缩短（t=7．622，P=0．005），术后疼痛症状极轻，但住院费用相对较高，二组术后并发症无统计学差异（x^2=1．529，P=0．144）；术后随访6—18个月，对照组未出现复发，观察组复发1例。结论TEP修补术治疗腹股沟疝具有手术时间短、住院时间短，且安全性高，复发率低，值得临床推广。

Objective To summarize experience of adult inguinal hernia repair, and to compare the clinical effect of total extraperitoneal laparoscopic repair （TEP） and Lichtenstein repair. Methods A retrospective analysis was conducted on 220 cases of adult inguinal hernia, from January 2012 to October 2013, 118 of whom underwent Lichtenstein repair （as control group）, and 102 underwent total extraperitoneal laparoscopic repair （as observation group）. The operating time, length of postoperative stay, complications rate, pain score, costs and recurrence were compared between the two groups. Results Laparoscopic group significantly shortened the length of hospital stay and had light postoperative pain, when compared with the control group （ t = 7. 622, P = 0. 005 ）, but the hospital costs were relatively higher. Postoperative complications of the two groups had no statistical difference （x^2 = 1. 529, P = 0. 144 ）. Postoperative follow-up at 6 to 18 months revealed one case of recurrence in observation group and none in control group. Condusion In this comparative study, TEP has proven to be a safe and effective procedure to reduce operating time, length of stay and recurrence, and is worthy to be popularized in clinic.