采用生物补片进行腹腔镜与开腹无张力疝修补术治疗腹股沟嵌顿疝的疗效对比

Efficacy comparison of laparoscopic versus open tension-free hernia repair using biologic mesh for inguinal strangulated hernia

目的比较采用生物补片进行腹腔镜与开腹无张力疝修补术治疗腹股沟嵌顿疝的临床效果。方法州顾性分析陕西省人民医院2012年1月至2014年4月间收治的27例腹股沟嵌顿疝患者的临床资料。均为急诊手术，均采用生物补片一期行无张力疝修补术，其中14例行开腹手术，13例行腹腔镜手术。结果腹腔镜组患者手术时间较开腹组明显缩短[（90．8±11．6）min比（130．8±32．5）min，P〈0．01]，术后血（清）肿发生率和伤口感染率明显降低[7．7％（1／13）比42．9％（6／14）和0比28．6％（4／14），均P〈0．05]，术后肠功能恢复时间和术后住院时间明显缩短[（2．5±0．3）d比（3．8±1．4）d和（6．3±1．8）d比（9．8±3．2）d．均P〈0．01]。结论对于急诊嵌顿疝的一期修补，在腹腔镜下应用生物补片行无张力疝修补术较开腹手术优势明显，可缩短手术时间，加快术后肠功能恢复，减少术后并发症发生率。

Objective To compare the efficacy of laparoscopic versus open tension-free mesh repair using biologic mesh for inguinal strangulated hernia. Methods Clinical data of 27 patients with inguinal strangulated hernia in the Shanxi Provincial People＇s Hospital between January 2012 and April 2014 were analyzed retrospectively. All the patients underwent one-stage tension-free repair using biological mesh, including laparoscopic （n=13） and open procedures （n=14）. Results As compared with the open group, the laparoscopic group had shorter operative time [ （90.8±11.6） rain vs. （130.8±32.5） rain, P〈0.01 ], lower rates of hematoma/seroma and wound infection [ （7.7% vs. 42.9%） and （0 vs. 28.6%） respectively, both P〈0.05], faster recovery of bowel function [（2.5±0.3） d vs. （3.8±1.4） d, P〈0.01], and shorter hospital stay [（6.3±1.8） d vs. （9.8±3.2） d, P〈0.01]. The mean followup was 5.7 months （ranged from 2 to 12 months）, and no recurrence or serious complications oceurred. Conclusion Laparoscopic tension-free hernia repair using biological mesh for inguinal strangulated hernia has significant advantage versus open operation.