3D腹腔镜与2D腹腔镜下经腹腹膜前腹股沟疝修补术的疗效比较

Comparison of the efficacy of 3D laparoscopic and 2D laparoscopic transabdominal preperitoneal inguinal hernia repair

目的探讨3D腹腔镜下经腹腹膜前腹股沟疝修补术的临床优势。方法回顾性分析2016年2月至2017年5月,鞍钢集团总医院60例行腹腔镜经腹腹膜前疝修补术(laparoscopic transabdominal preperitoneal hernia repair,TAPP)手术患者的临床资料,按照手术方式分为3D腹腔镜组和2D腹腔镜组,每组患者30例。观察比较3D组和2D组患者术中出血量、手术时间、术后住院时间、住院费用及术后并发症。结果本组60例腹腔镜TAPP手术均顺利完成手术。3D组手术时间(65±24.5)min短于2D组(78±25.6)min,差异有统计学意义(P<0.05);2组术中出血量、术后住院时间、住院费用比较,差异无统计学意义(P>0.05);术后2组共出现5例阴囊血清肿,组间比较差异无统计学意义(P>0.05),2组均未出现尿潴留、暂时性感觉神经障碍、慢性疼痛等并发症。结论 3D腹腔镜技术极大改善了外科医师的手眼配合度,提供了最精确的空间定位,降低手术操作难度,缩短了手术时间及学习曲线。

Objective To explore the clinical advantages of 3D laparoscopic transabdominal preperitoneal inguinal hernia repair（TAPP）.Methods From February 2016 to May 2017,60 patients who underwent TAPP surgery in Ansteel Group Hospital were randomly divided into 3D laparoscopic group and 2D laparoscopic group,30 patients in each group.The intraoperative blood loss,operation time,postoperative hospital stay,hospitalization cost and postoperative complications were observed and compared between the 3D group and 2D group.Results This group of 60 patients with laparoscopic TAPP surgery successfully completed the operation.The operation time of the 3D group was shorter than that of the 2D group,and the difference was statistically significant（P0.05）.There was no significant difference in the amount of intraoperative blood loss,postoperative hospital stay,and hospitalization cost between the two groups（P0.05）.There were 5 cases of scrotal seroma in the two groups.There was no difference between the two groups（P0.05）.There were no complications such as urinary retention,temporary sensory neuropathy and chronic pain in the two groups.Conclusion The 3D laparoscopic technique greatly improves the surgeon＇s hand-eye fit,provides the most accurate spatial positioning,reduces the difficulty of surgical operation,and shortens the operation time and learning curve.