TAPP与Lichtenstein两种术式治疗腹股沟疝的疗效对比分析

Comparative Analysis on the Effect of TAPP and Lichtenstein Operation on the Treatment of Inguinal Hernia

目的观察腹股沟疝运用腹腔镜经腹腹膜前疝修补术(Transabdominal preperitoneal,TAPP)与开放式无张力疝修补术(Lichtenstein)的疗效比较,探究腹股沟疝外科治疗的高效手术方式。方法回顾性分析2014-09/2016-09期间在中山市中医院接受手术治疗的60例腹股沟疝的病历资料,按不同手术方式分为TAPP术治疗组、Lichtenstein术治疗组。比较两组患者手术时间、术后疼痛等手术指标以及下床活动时间、住院时间等住院指标,并记录两组患者术后各项并发症的发生情况。结果 TAPP术治疗组手术时间显著高于Lichtenstein术治疗组,术后24 h疼痛VAS评分、术中出血量低于Lichtenstein术治疗组,差异有统计学意义(P<0.01);TAPP术治疗组下床活动时间、进食时间、住院时间等住院指标低于Lichtenstein术治疗组,住院费用高于Lichtenstein术治疗组,差异有统计学意义(P<0.01);TAPP术治疗组发生尿潴留、阴囊水肿等并发症发生率为10%,低于Lichtenstein术治疗组(20%),差异有统计学意义(P<0.01)。结论 TAPP术在治疗腹股沟疝过程中,手术时间及费用要高于Lichtenstein术,但TAPP术更具有微创性优点,各项住院指标较优,并发症控制效果更佳,综合比较TAPP更具临床优势。

Objective To compare the effect of the laparoscopic Tran abdominal preperitoneal TAPP with the open tension-free herniorrhaphy Lichtenstein in the treatment of inguinal hernia and explore the efficient operation of inguinal hernia surgery. Methods Retrospectively analyzing the medical records of 60 inguinal hernia cases undergone surgical treatment from September 2014 to September 2016,the study divided the patients into two groups according to the different surgical methods,one was the TAPP group and the other was the Lichtenstein group. The paper compared the sugery indicators, such as the operative time,postoperative pain and the hospitalization indicators such as ambulation time,hospitalization time between the two groups,and recorded the postoperative complications. Results The operative time of the TAPP group was significantly higher than that of the Lichtenstein group. The 24 h pain VAS score after operation and intraoperative bleeding were lower than those of the Lichtenstein group P 0. 01 . The hospitalization indicators of the TAPP group was lower than those of the Lichtenstein group,and the TAPP group s hospitalization cost was higher than the Lichtenstein group s P 0. 01 . The incidence of complications such as urinary retention and scrotal edema was 10% in the observation group,which was lower than that in the control group 20% ,with statistical significance P 0. 01 . Conclusion It is found that although the operation time and cost of TAPP in the treatment of inguinal hernia were higher than Lichtenste,it had more clinical advantages of minimal invasion,better results in hospitalization indicators and control of complications according to the comprehensive comparison.