比较经腹腹膜前腹股沟疝修补术中应用3D免钉合补片与普通平片的临床随机对照试验

Prospective randomized clinical trial comparing 3D non-stapled mesh and polypropylene mesh in transabdominal preperitoneal repair for inguinal hernia

目的:对比腹腔镜经腹腹膜前腹股沟疝修补术(transabdominal preperitoneal,TAPP)中应用免钉合的3D补片与普通平片对手术效果的影响。方法:收集2013年7月至2014年9月110例单侧腹股沟疝男性患者,将其随机分为3D组与平片组行TAPP。结果:103例患者获得随访,两组手术时间、术后住院时间及术后便秘、尿潴留发生情况差异无统计学意义。在术后疼痛情况、生活质量方面,3D组较平片组占优,且住院费用及术后血清肿发生率较低。结论:TAPP术中使用3D补片较普通平片能有效提升患者术后生活质量,减轻术后疼痛,降低术后血清肿发生率且花费较少。

Objective： A prospective randomized trial was undertaken to compare 3D non-stapled mesh and polypropylene （PP） mesh in transabdominal preperitoneal （TAPP） repair of inguinal hernia. Methods：From Jul. 2013 to Sep. 2014,110 male pa- tients diagnosed as primary unilateral inguinal hernia were randomized into 3D Group and PP Group. After TAPP, quality of life, postop- erative complications and recurrence were documented during 6-month follow-up. Results：By analyzing 103 patients who completed the follow-up, no recurrence occurred in either group. Operative time, postoperative hospital stay, constipation, dysuria had no significantly statistical differences between two groups. Scores of QOL-35 and VAS in PP Group was lower than 3D Group and both of them had sig- nificant statistical differences （P 〈0.05 ）. The cost of 3D Group was less than PP Group （P = 0. 035 ） and the rate of postoperative se- roma in 3D Group was lower than PP Group （P = 0. 013 ）. Conclusions：In TAPP, the use of 3D non-stapled mesh could reduce the in- cidence of chronic groin pain, seroma and improve the quality of patients＇ life with less cost than PP mesh.