腹腔镜经腹腹膜前疝修补术(TAPP)与填充式无张力疝修补术临床疗效比较

Clinical study on laparoscopic transabdominal preperitoneal repair( TAPP ) and plug-mesh tension-free hernioplasty for inguinal hernia

目的:探讨腹腔镜经腹腹膜前疝修补术与填充式无张力疝修补术的临床疗效。方法:回顾分析113例成人腹股沟疝患者的临床资料,其中腹腔镜组57例(TAPP观察组),填充式组56例(对照组)。比较两组患者的切口长短、手术时间、术中出血量、术后首次下床活动时间、术后恢复肠道功能,术后并发症发生情况,并记录两组患者的住院时间及总资源费用,术后随访24个月,比较两组术后复发率。结果:TAPP组切口长短、手术时间、术中出血量、术后首次下床活动时间、术后恢复肠道功能均低于填充式无张力疝修补组,差异均有统计学意义(P均<0.05);观察组患者的住院时间亦少于对照组,差异有统计学意义(P均<0.05),观察组住院总费用高于对照组,差异有统计学意义(P<0.05),术后并发症方面观察组切口感染率、腹股沟血清肿及阴囊水肿等发生率低于对照组,差异均有统计学意义(P<0.05)。两组患者术后均无复发。结论:腹腔镜经腹腹膜前修补术治疗成人腹股沟疝住院费用高,但手术时间短、术后康复快、并发症低,值得临床推广。

Objective To compare the clinical effect of laparoscopic transabdominal preperitoneal repair（ TAPP） and plug-mesh tension-free hernioplasty. Method A total of 113 patients with inguinal hernia were analyzed retrospectively,including 57 patients of laparoscopic group（ TAPP observation group） and 56 cases of plug-mesh group（ control group）. The incision length,operation time,intraoperative bleeding loss,postoperative ambulation time,postoperative intestinal function recovery,and overall complications rate,were compared and analyzed. The hospitalization time and the total resource cost were also recorded. After 24 months of follow-up,the recurrence rate of the two groups was compared. Results The incision length,operation time,intraoperative bleeding loss,postoperative ambulation time,postoperative intestinal function recovery,overall complications rate of TAPP group was shorter than that in control group（ P 〈 0. 05）. The hospitalization time of TAPP group was shorter than that in control group（ P 〈 0. 05）. The total resource cost of TAPP group was more than control group（ P 〈 0. 05）. The incisional infection,the incidence of inguinal swelling and scrotal edema of TAPP group was shorter than that in control group（ P 〈 0. 05）.There was no recurrence in both groups. Conclusion Laparoscopic transabdominal preperitoneal repair of inguinal hernia for the treatment of adult hernia is expensive,but the operation time is shorter,the postoperative rehabilitation is quick and the complication is low and deserves clinical promotion.