腹腔镜与开放性腹壁切口疝修补术的疗效对比

Efficacy comparison of laparoscopic and open abdominal incisional hernia repair

目的比较腹壁切口疝患者行腹腔镜腹壁切口疝修补术与开放性腹壁切口疝修补术的疗效。方法回顾性分析2011年2月～2016年1月在我院接受腹壁切口疝手术治疗的61例患者的临床资料,按手术入路分为腹腔镜组(30例)与开放组(31例)。比较两组患者的术中出血量、手术时间、使用引流管率、术后疼痛(止痛药使用时间)、排气时间、术后并发症发生率、术后住院时间及慢性疼痛率和复发率。结果腹腔镜组患者的术中出血量少于开放组,使用引流管率低于开放组,术后住院时间短于开放组,差异有统计学意义(P<0.01)。两组患者的手术时间、术后疼痛、排气时间、术后并发症总发生率、慢性疼痛率及复发率比较,差异无统计学意义(P>0.05)。结论腹腔镜腹壁切口疝修补术疗效与开放性手术相同,但具有手术创伤小、术后住院时间短的优点。

Objective To compare the efficacy of laparoscopic and open incisional hernia repair in patients with abdominal incisional hernia. Methods The clinical data of 61 patients who underwent abdominal incisional hernia surgery in our hospital from February 2011 to January 2016 were retrospectively analyzed. They were divided into the laparoscopic group (30 cases) and the open group (31 cases) according to the surgical approach. The intraoperative bleeding volume, the operation time, the rate of using drainage tube, the postoperative pain (the duration of analgesics use), the first flatus time, the incidence of postoperative complication, the length of postoperative hospital stay, the chronic pain rate and the recurrence rate were compared between the two groups. Results The intraoperative bleeding volume in the laparoscopic group was less than that in the open group, and the rate of using drainage tube in the laparoscopic group was lower than that in the open group, and the length of postoperative hospital stay in the laparoscopic group was shorter than that in the open group, the differences were statistically significant (P<0.01). However, there were no significant differences in the operation time, the postoperative pain, the first flatus time, the total incidence rate of postoperative complication, the chronic pain rate and the recurrence rate between the two groups (P>0.05). Conclusion The laparoscopic abdominal incisional hernia repair has the same effect as the open operation, but it has the advantages of minimal invasion and shorter postoperative hospital stay.