自固定补片和聚丙烯平片在腹腔镜下完全腹膜外腹股沟疝修补术中的应用及复发对比研究

Comparative study on the application and recurrence of self-fixation patch and polypropylene plain flm in laparoscopic total extraperitoneal repair

目的对比自固定补片和聚丙烯平片在腹腔镜下完全腹膜外腹股沟疝修补术(TEP)中的应用效果及复发情况。方法选取2015年1月～2017年1月在我院外科经腹腔镜TEP治疗的76例腹股沟疝患者为研究对象,将其中38例应用聚丙烯平片的设为对照组,将另38例应用自固定补片的设为实验组,比较两组的疗效、安全性及复发率差异。结果所有患者均顺利的完成手术,经观察,两组的术中出血量比较差异无统计学意义(P> 0.05),但实验组的住院时间显著短于对照组,手术时间及住院费用显著多于对照组(P<0.05);术后,两组的血清肿、阴囊气肿发生率比较差异无统计学意义(P> 0.05),但实验组的慢性疼痛、异物感发生率显著低于对照组(P <0.05);随访观察1年,两组均未见复发患者。结论应用自固定补片进行腹腔镜下完全腹膜外疝修补术需要未能明显降低并发症,但可明显减轻患者疼痛及减少复发风险,有利于患者恢复,改善疾病预后,具有临床推广价值,但其远期疗效及复发情况仍需临床加以研究观察。

Objective To compare application effects and recurrence of self-fixation patch and polypropylene plain film in laparoscopic total extraperitoneal repair(TEP).Methods Seventy-six patients with inguinal hernia who were treated with laparoscopic TEP in our hospital from January 2015 to January 2017 were selected as research objects.Among whom,38 patients with application of polypropylene plain film were set as the control group and other 38 patients with application of self-fixation patch were set as the experimental group.Curative effects,safety and recurrence rate of two groups were compared.Results Operationsof all patients were successfully completed.After observation,there was no significant difference in intraoperative blood loss between the two groups(P>0.05).But the hospitalization stay in the experimental group was significantly shorter than that in the control group,and the operation time and hospitalization expenses were significantly higher than those in the control group(P<0.05).After operation,there was no statistical significance in the incidence of seroma and scrotal emphysema between the two groups(P>0.05).But the incidence of chronic pain and foreign body sensation in the experimental group was significantly lower than those in the control group(P<0.05).After 1 year of follow-up,no recurrent patients were found in two groups.Conclusion It is suggested that the application of self-fixation patch inin laparoscopic total extraperitoneal repair can’t significantly reduce the complications,but can significantly reduce pain of patients and risk of recurrence.It is beneficial to the recovery of patients,improve the prognosis of the disease and it has the value of clinical promotion.However,the long-term clinical effect and the recurrence of the disease still need to be clinically studied and observed.