自固定补片在腹腔镜完全腹膜外腹股沟疝修补术中的临床应用

The Clinical Application of Total Extraperitoneal Inguinal Herniorrhaphy with Laparoscopic Technique Using An Innovative Self-Gripping Mesh

目的对比分析腹腔镜完全腹膜外腹股沟疝修补术中分别使用自固定补片和聚丙烯平片的临床应用效果。方法回顾性分析笔者所在医院2012年6月至2015年3月期间收治并进行随访的142例单侧腹股沟疝患者的临床资料,所有患者均行腹腔镜全腹膜外修补术（TEP）。根据使用的补片不同,将患者分为自固定补片组（n=60）和聚丙烯平片组（n=82）。比较2组患者的疗效指标。结果 2组患者的手术时间、术中出血量、术后住院时间及术后各时点（术后12、24、48及72 h）的疼痛评分（VAS评分）比较差异均无统计学意义（P〉0.05）。在并发症方面,2组患者的总并发症、阴囊水肿、腹股沟区血清肿、膀胱损伤、腹壁下血管损伤及尿潴留发生率比较差异均无统计学意义（P〉0.05）。术后2组患者均获访,随访时间为3-36个月,中位数为19个月。随访期间2组患者均未复发。结论自固定补片在腹腔镜TEP中的应用是安全有效的,可能是未来补片发展的趋势。

Objective To compare the efficiency of total extraperitoneal inguinal herniorrhaphy with laparoscopic technique using an innovative self-gripping mesh and polypropylene mesh. Methods The clinical data of 142 cases of unilateral inguinal hernia who underwent total extraperitoneal prosthesis（TEP） in our hospital form June 2012 to March 2015 were retrospectively analyzed. The operation type was total extraperitoneal inguinal herniorrhaphy with laparoscopic technique. Depending on the kind of mesh, all patients were divided into two groups from the self-gripping mesh group（n=60） and the polypropylene mesh group（n=82）. Results There was no significant difference in the operation time, intraoperative blood loss, hospital stay, and The Visual Analogue Score of post-operative（at 12, 24, 48, and 72 hours after operation） between the 2 groups（P〉0.05）. On the post-operative complications, there was no significant difference in incidences of total complication, scrotal edema, seroma, bladder injury, vascular injury of abdominal, and urinary retention too（P〉0.05）. All the patients were followed up for 3-36 months（the median time was 19-month）, and no recurrence occurred during the follow-up period. Conclusions Innovative self-gripping mesh is safe and effective, and maybe a good direction of mesh for material development.