优化超声刀与电刀的综合使用在完全腹膜外疝修补术中的影响

The influences of optimizing the comprehensive use of ultracision-harmonic scalpel and high frequency electrotomy in laparoscopic total extraperitoneal inguinal hernioplasty

目的对比单独/综合使用超声刀(UHS)和高频电刀(HFE)在完全腹膜外疝修补术(TEP)中,对术后并发症及复发率的影响,以评价其安全性和可行性。方法将2010年1月至2014年12月中山大学附属汕头医院(汕头市中心医院)213例研究对象随机分成综合应用UHS和HFE组(A组),单独应用UHS(B组)和HFE(C组)各71例。在腹腔镜下行TEP手术。对各项临床资料、术中及术后早期及远期随访情况进行评估。结果三组术中未发生并发症。术后早期及远期的并发症、复发率比较差异有统计学意义(P<0.05)。结论在TEP术中单独/综合使用HFE和UHS均是安全有效可行的,综合使用HFE和UHS,优化其各自长处可降低其术后并发症并获得最佳的临床效果。

Objective To evaluate the safety and feasibility of ultracision-harmonic scalpel（ UHS）and high frequency electrotomy（ HFE）,when they are used singly or comprehensively in laparoscopic total extraperitoneal inguinal hernioplasty（ TEP）, and to compare their influences to the postoperative complications and recurrence rate. Method A total of 213 patients who underwent TEP were divided randomly into three groups： UHS and HFE were comprehensively used in group A,UHS was used alone in group B,and HFE was used in group C,with 71 cases in each group. The clinical data,intraoperative condition,early and late postoperative follow-up were assessed. Result Of these three groups,there were no complications during the operation. The differences of early and long-term postoperative complications and recurrence between three groups were statistically significant（ P〈 0. 05）. Conclusion Separately or comprehensively using UHS and HFE are both safe,effective and feasible. When comprehensively using UHS and HFE and optimizing their advantages will reduce the postoperative complications and get the best clinical results.