腹腔镜经腹腔腹膜前疝修补术与疝环充填式修补术治疗成人腹股沟疝的对比研究

Laparoscopic transabdominal preperitoneal herniorrhaphy versus mesh-plug tension-free hernioplasty for inguinal hernia in adult patients

目的与疝环充填式无张力修补术对比，回顾性分析腹腔镜经腹腔腹膜前疝修补术（TAPP）治疗腹股沟疝的效果。方法选取2014年1月至2016年12月本院开展的62例腹腔镜经腹腔腹膜前疝修补术患者为TAPP组，同期行疝环充填式无张力疝修补术88例患者为对照组。对比两组患者的住院时间、住院费用、疼痛评分、术后并发症（切口感染、血清肿、缺血性睾丸炎、复发）等。结果与对照组相比，TAPP组平均住院时间[（3．4±1．53）d比（6．5±2．71）d，P=0．003]、疼痛评分[（2．15±1．13）比（5．78±2．27），P=0．013]、总并发症发生率（3．22％比12．5％，P=0．047）均更少；住院费用增多[（13246．7±1238．5）元比（7852．5±533．8）元，P=0．0016]，差异有统计学意义。结论腹腔镜经腹腔腹膜前疝修补术是安全有效的，具有微创、疼痛轻、恢复快等优点。

Objective To retrospectively analyze the clinical efficiency of laparoscopic transabdominal preperitoneal hernioplasty （TAPP） in the treatment of inguinal hernia, compared to mesh-plug tension-free hernioplasty. Methods From January 2014 to December 2016, 62 patients in our hospital who underwent laparoscopic transabdominal preperitoneal hemioplasty were as TAPP group, 88 patients who underwent meshplug tension-free hernioplasty during the corresponding period were as control group. We observed the length of stay, hospitalization expenses, pain score, postoperative complications （incision infection, seroma, ischemic orchitis, recurrence）. Results In TAPP group, the length of stay [（3.4±1.53）d vs.（6.5±2.71）d, P=0.003], pain score [（2.15±1.13） point vs.（5.78±2.27） point, P=0.013], postoperative complications （3.22% vs. 12.5%, P=-0.047） were less than those in control group; the hospitalization expenses [（13 246.7±1 238.5） RMB vs.（7 852.5±533.8） RMB, P=-0.0016] in TAPP group was more than that in control group, with statistically significant differences. Conelusion TAPP is safe and effective for inguinal hernia patients, which has the advantages of minimally invasive, ache light, recover fast.