腹腔镜完全腹膜外疝修补术与经腹腹膜前疝修补术的临床疗效对比

Comparison of the clinical efficacy of laparoscopic totally extraperitoneal hernia repair and transabdominal preperitoneal prosthesis

目的:探讨腹腔镜完全腹膜外疝修补术(totally extraperitoneal,TEP)与经腹腹膜前疝修补术(transabdominal preperitoneal,TAPP)的临床应用价值。方法:选取2012年6月至2013年12月收治的90例腹股沟疝患者。随机分为TEP组与TAPP组。对比分析两组患者的手术时间、术后疼痛时间、住院时间、住院费用、并发症发生情况及复发例数等。结果:与TAPP组相比,TEP组手术时间、术后疼痛时间及住院时间明显缩短,且住院费用明显降低,差异均有统计学意义(P<0.05)。两组阴囊血清肿、术后暂时性神经感觉异常及尿潴留等并发症发生率、腹股沟疝复发率差异无统计学意义(P>0.05)。结论:对于腹股沟疝患者而言,TEP可进一步缩短术后疼痛时间,减轻患者的经济负担,但对术者的操作熟练程度要求较高,有待进一步推广应用。

Objective： To probe into clinical application value of laparoscopic totally extraperitoneal hernia repair（ TEP） and transabdominal preperitoneal prosthesis（ TAPP）. Methods： From Jun. 2012 to Dec. 2013,90 inguinal hernia patients were selected. The patients were divided into TEP group and TAPP group randomly. The operative time,time of postoperative pain,length of hospital stay,cost of hospitalization,complications and recurrence ratio of the patients in two groups were compared and analyzed. Results： Compared with TAPP group,the operative time,time of postoperative pain,and length of hospital stay of the patients in TEP group was significantly shorter,and the cost of hospitalization was reduced significantly,there were statistically significant differences（ P〈0. 05）. The incidence of complications,including scrotum seroma,postoperative transient nerve paresthesia and urinary retention,and the ratio of postoperative inguinal hernia recurrence of the two groups were not statistically significantly different（ P〈0. 05）. Conclusions： For inguinal hernia patients,TEP could further reduce time of postoperative pain and the financial burden on patients. But it requires high operating proficiency of doctor,it need further application.