TAPP与开放式腹膜前间隙腹股沟疝无张力修补术的临床效果比较

Comparative Study of Clinical Effect of Laparoscopic Transabdominal Preperitoneal Hernia Repair and Open Preperitoneal Hernia Repair for Inguinal Hernia

目的对比腹腔镜经腹膜前疝修补术(TAPP)与开放式腹膜前间隙腹股沟疝无张力修补术的临床应用价值。方法回顾性分析2013年3月至2015年3月汉中市中心医院普通外科收治的78例腹股沟疝(均为单侧腹股沟疝)患者的临床资料,依据治疗方法不同分为观察组和对照组,各39例。观察组行TAPP治疗,对照组行开放式腹膜前间隙腹股沟疝无张力修补术治疗。对两组患者的临床疗效进行比较分析。结果观察组手术时间短于对照组[(52±12)min比(60±15)min],排气时间晚于对照组[(16.8±1.9)h比(12.4±1.6)h],镇痛药应用比例低于对照组[17.9%(7/39)比38.5%(15/39)],差异有统计学意义(P<0.05)。两组患者术后并发症、复发及慢性疼痛发生率比较差异无统计学意义(P>0.05)。结论 TAPP与开放式腹膜前间隙腹股沟疝修补术是安全有效的,各有优势,临床上应根据患者的病情、医疗单位条件及患者经济情况等综合因素来选择相应的手术方式,均能达到良好的治疗效果。

Objective To explore the difference between laparoscopic transabdominal preperitoneal （TAPP） hernia repair and open preperitoneal （OPP） hernia repair for the treatment of inguinal hernia. Methods A total of 79 cases with inguinal hernia who underwent hernia repair in Hangzhong Central Hospi- tal from Mar. 2013 to Mar. 2015 were retrospectively analyzed. The patients were divided into an observation group and a control group according to the treatment method ,39 cases each. The observation group received TAPP hernia repair,and the control group received OPP hernia repair. The clinical curative effect of the two groups were compared and analyzed. Results The operation time of the observation group was less than the control group[ （52 ± 12 ） min vs （60 ± 15 ） min ], exhaust time was later than the control group [ （16.8 ± 1.9 ） h vs （ 12. 4 ± 1.6 ） h ], analgesics requirement ratio was lower than the control group [ 17.9 % （7/39） vs 38.5% （15/39）], the differences were statistically significant（ P 〈 0. 05 ）. Incidence of postoperative complications,recurrence and chronic pain of the two groups had no statistically significant differences（ P 〉 0.05）. Conclusion TAPP hernia repair and OPP hernia repair of inguinal hernia are both safe and effective, each with own advantages, which should be chosen according to the clinical condition of the patient, condition of the medical care organization and economic conditions of the patients, and both can achieve good treatment effect.