Kugel补片在腹腔镜腹股沟疝修补术中有效性和安全性的临床研究

Clinical study on the efficacy and safety of Kugel patch in laparoscopic inguinal hernia repair

目的探讨腹腔镜下使用巴德Kugel补片免钉合技术修补腹股沟疝可行性、有效性和安全性。方法回顾性分析2014年1月~2016年1月我科Kugel补片腹腔镜疝修补术(50例)和开放疝修补术(50例)两组患者的资料。记录患者的手术时间、住院时间、术后并发症发生率和复发率。结果两组患者性别、年龄、疝类型、出血量和住院时间等无明显差异。腹腔镜组平均每侧手术时间(75.0±2.8)min,而开放组平均每侧时间(40.0±1.6)min,两组相比统计学有显著性差异(P<0.05)。腹腔镜组术后12个月视觉模拟评分(visual analogue scale,VAS)为(0.52±0.08)分,而开放组为(0.75±0.05)分,其中有慢性疼痛2例(各为5分和6分)(P<0.05)。腹腔镜组无血肿,而开放组术后2例血肿,存在差异明显(P<0.05)。此外开放组有1切口感染,但差异统计学无意义(P>0.05)。两组平均随访时间(26.0±1.6)个月。无复发病例(P>0.05)。结论采用Kugel补片腹腔镜腹股沟疝修补术方法简单有效,安全可靠,具有术后疼痛少、费用低等优点。

Objective To investigate the feasibility, efficacy and safety of Bard Kugel patch non-nailing technique in laparoscopic repair of inguinal hernia. Methods The data of the two groups of patients in Kugel patch laparoscopic hernia repair group （50 cases） and open hernia repair group （50 cases） from January 2014 to January 2016 in our department were retrospectively analyzed. The operation time, length of stay, postoperative complications and recurrence rate were recorded in the patients. Results There was no significant differences in gender, age, hernia type, bleeding volume and length of stay between the two groups. The average surgery time of each side was （75.0±2.8） min in the laparoscopic group, while the average time of each side was（40.0±1.6） rain in the open group. The difference was statistically significant （P〈0.05）. The 12-month visual analogue scale （VAS） in the laparoscopic group after the surgery was （0.52＋0.08）, while the open group was （0.75±0.05）, including 2 cases of chronic pain （5 points and 6 points each） （P〈0.05）. Laparo- scopic group was without hematoma, and open group had 2 cases of hematoma after surgery. There were significant differences（P〈0.05）. In addition, the open group had one case of wound infection, but there was no statistical significances （P〉0.05）. There were no recurrence cases during the average follow-up time of （26.0±1.6） months （P〉0.05）. Conclusion Kugel patch laparoscopic inguinal hernia repair method is simple, effective, safe and reliable, with the advantages of tess postoperative pain and low cost.