腹腔镜下钩针法疝环闭合术治疗成人腹股沟斜疝90例临床观察

Clinical observation of laparoscopic surgery with the ring closure methods for 90 cases of adult indirect inguinal hernia

目的观察腹腔镜下钩针法疝环闭合术治疗成人腹股沟斜疝的临床疗效。方法将180例成人腹股沟斜疝患者随机分为2组,各90例。对照组采用腹腔镜下经腹腔腹膜前间隙疝修补术治疗,治疗组采用腹腔镜下钩针法疝环闭合术治疗,观察并比较2组患者的手术时间、术中出血量、术后住院时间、住院费用、术后疼痛评分及术后并发症情况等。结果治疗组手术及术后住院时间明显缩短,术中出血量明显减少,住院费用及术后疼痛评分显著降低,与对照组比较差异均有统计学意义(P<0.05或P<0.01);治疗组阴囊血肿或血清肿及切口感染直径明显小于对照组,2组比较差异均有统计学意义(P<0.01)。结论腹腔镜下钩针法疝环闭合术治疗成人腹股沟斜疝安全可行,并且操作简单、并发症少、术后疼痛轻、恢复快、复发率低,具有一定的优越性,值得推广。

Objective To observe the clinical effect of laparoscopic crochet closure of the inguinal hernia in adults. Methods 180 adult patients with inguinal hernia were randomly divided into 2 groups,90 cases in each. The control group was treated with laparoscopic transperitoneal preperitoneal space hernia repair. The treatment group was treated with laparoscopic crochet ring closure. The operation time,intraoperative blood loss,postoperative hospital stay, hospital costs, postoperative pain score and postoperative complications were observed and compared between the two groups. Results The time of surgery and postoperative hospital stay was significantly shorter in the treatment group. The amount of intraoperative blood loss was significantly reduced, hospitalization costs and pain scores were significantly reduced,and there was a significant difference between the treatment group and the control group （P〈0.05 or P〈0.01 ）. The diameter of hematoma or seroma and wound infection was significantly smaller than that of the control group. There was significant difference between the two groups（P〈0.01）. Conclusion Laparo- scopic crochet closure of the indirect inguinal hernia in adults is safe and feasible, and it is easy to operate,less complications, postoperative pain, rapid recovery, low recurrence rate. It has certain advantages and is worthy of promotion.