腹腔镜经腹腹膜前疝修补术与开放式无张力疝修补术治疗成人腹股沟疝的临床对比研究

Clinical comparison of laparoscopic transabdominal preperitoneal and open tension-free herniorrhaphy for adult inguinal hernia

目的:探讨腹腔镜经腹腹膜前疝修补术与开放式无张力疝修补术的临床疗效。方法:回顾分析2012年8月至2015年2月诊治的128例成人腹股沟疝患者的临床资料,其中76例行腹腔镜经腹腹膜前疝修补术(腹腔镜组),52例行开放式无张力疝修补术(开放组)。结果:腹腔镜组手术时间长于开放组,住院费用高于开放组,差异有统计学意义(P<0.05);住院时间、恢复肠道功能时间腹腔镜组优于开放组,差异有统计学意义(P<0.05)。术后并发症发生率腹腔镜组为6.6%(5/76),开放组为19.2%(10/52),两组相比差异有统计学意义(P<0.05)。两组患者术后均无复发。结论:腹腔镜经腹腹膜前疝修补术虽然手术时间长,住院费用高,但术后康复快,并发症少,临床疗效显著。

Objective： To compare the clinical effect of laparoscopic transabdominal preperitoneal and open tension-free herniorrhaphy. Methods： The clinical data of 128 adult patients with inguinal hernia in the People＇s Hospital of Xiajin between Aug. 2012 and Feb. 2015 were retrospectively analyzed. 76 patients underwent laparoscopic transabdominal preperitoneal herniorrhaphy（ laparoscopic group） and 52 patients underwent open tension-free herniorrhaphy（ open group）. Results： The mean operating time was（ 68. 6 ±9. 5） min in laparoscopic group,and（ 48. 4 ± 5. 4） min in open group（ P 〈 0. 05）. The hospital stay was（ 3. 5 ± 1. 0） d in laparoscopic group,and（ 7. 5 ± 1. 5） d in open group（ P 〈 0. 05）. Hospitalization expense was（ 8 526 ± 1 452） yuan in laparoscopic group,and（ 5 845 ± 1 235） yuan in open group（ P 〈 0. 05）. Time of resumption of gastrointestinal function was（ 1. 5 ± 0. 5） d in laparoscopic group,and（ 2. 0 ± 0. 5） d in open group（ P 〈 0. 05）. The incidence of laparoscopic postoperative complications was 6. 6%（ 5 /76）,which was significantly less than 19. 2%（ 10 /52） in open group（ P 〈 0. 05）. Recurrence rate of both groups was 0. Conclusions： Despite long operation time and high hospital cost,laparoscopic transabdominal preperitoneal herniorrhaphy leads to short hospital stay,quick postoperative recovery and few postoperative complications,with significantly clinical effect.