免钉合双网片交叠腹腔镜腹膜外腹股沟疝修补术与Lichtenstein疝修补术的对比研究

Comparative study of laparoscopic extraperitoneal inguinal hernia repair with unfixed overlapped double-mesh and Lichtenstein repair

目的:对比分析免钉合双网片交叠腹腔镜全腹膜外疝修补术(totally extraperitoneal,TEP)与Lichtenstein修补术治疗腹股沟疝的临床应用价值。方法:为80例腹股沟疝患者分别行免钉合双网片交叠腹腔镜TEP(TEP组)与Lichtenstein修补术(对照组),每组40例。收集两组患者围手术期资料并进行对比。结果:TEP组手术时间长,住院费用高,术后住院时间短,术后镇痛例数少(P<0.05),两组术后并发症发生率、复发率差异无统计学意义(P>0.05)。结论:免钉合双网片交叠TEP安全、有效、可行,尽管手术时间长、住院费用高,但术后疼痛轻、康复快、住院时间短,符合现代人对生活质量的要求。对于有丰富腹腔镜腹股沟疝修补经验的外科医生,免钉合双网片交叠TEP可作为临床治疗腹股沟疝的实用手术方法。

Objective ：To compare the clinical application value of unfixed double-mesh overlapping laparoscopic totally extrap- eritoneal （TEP） hemiorrhaphy and Liehtenstein hemiorrhaphy in the treatment of inguinal hernia. Methods： Eighty inguinal hernia patients were equally divided into unfixed double-mesh overlapping laparoscopic TEP hemiorrhaphy group and Lichtenstein hemiorrhaphy group. The perioperative data of two groups were collected and comparatively analyzed. Results： TEP group featured longer operation time, higher hospitalization costs, shorter postoperative hospital stay and less postoperative analgesia cases （ P 〈 0.05 ）. Differences of postoperative complications and recurrence rate were not statistically significant （ P 〉 0.05 ）. Conclusions： Unfixed double-mesh overlapping TEP is safe, efficient and feasible ;in spite of longer operation time and higher hospitalization cost,it has the advantages of less postoperative pain, shorter recovery time and hospital stay in accordance with the modem requirements of life quality. Unfixed doublemesh overlapping TEP can be used as a clinical practical operation method for surgeons with rich experience in laparoscopic inguinal hernia repair.