TAPP与Lichtenstein术治疗成人腹股沟复发疝的疗效对比

Comparision of Laparoscopic transabdominal preperitoneal hernia repair and Lichtenstein repair in the treatment of recurrent inguinal hernia in adults

目的比较腹腔镜经腹腹膜前疝修补术(TAPP)与Lichtenstein术治疗成人腹股沟复发疝的临床疗效。方法回顾性分析汉川市人民医院2012年1月至2016年6月收治的97例腹股沟复发疝患者临床资料,并根据治疗方法分成2组,其中49例行TAPP术者分为研究组,48例行Lichtenstein术者分为对照组,观察2组患者的切口长度、手术时间、术中出血量、术后下床活动时间、平均住院时间等临床指标及术后切口血清肿、阴囊血肿、术后疼痛、排尿困难、疝再次复发等并发症的发生率,并进行统计学分析。结果在临床指标方面,研究组手术时间与对照组比较,差异无统计学意义(P>0.05),切口长度、术中出血量、术后首次下床活动时间及平均住院时间等均显著低于对照组,差异有统计学意义(P<0.05);在并发症方面,研究组术后总并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论 TAPP术治疗成人腹股沟复发疝并发症明显少于Lichtenstein术,且具有微创优势,值得在临床推广。

Objective Comparing clinical curative effect of laparoscopic transabdominal preperitoneal hernia repair（ TAPP） and Lichtenstein repair for the treatment of adult recurrent inguinal hernia. Methods A retrospective analysis was conducted on 97 patients with recurrent inguinal hernia in Hanchuan People＇s Hospital from January 2012 to June 2016. According to the treatment,the patients was divided into two groups,including 49 cases of TAPP repair in the study group,48 cases of Lichtenstein repair in the control group. The incision length,operative time,intraoperative blood loss,postoperative leaving bed time,average length of hospital stay and other clinical indicators were recorded,and the incidence of complications such as postoperative incisional seroma,scrotal hematoma,postoperative pain,dysuria,hernia re-recurrence,were analyzed. Results In clinical indicators,there was no significant difference in the operation time between the study group and the control group（P〈0. 05）. The incisions length,intraoperative blood loss,postoperative activity time and average length of hospital stay in the study group were significantly lower than those in the control group（P〈0. 05）; In terms of complications,the total complication rate in study group was significantly lower than that in the control group（P〈0. 05）.Conclusion TAPP repair for adult recurrent inguinal hernia is superior to Lichtenstein repair in complications,and has the advantages of minimally invasive,and is worth popularizing in clinical.