TAPP疝修补术不同腹膜关闭方式的临床研究

Study on Different Methods of Peritoneal Closure in TAPP Hernia Repair

目的探讨腹腔镜经腹腹膜前疝修补术(transabdominal preperitoneal,TAPP)不同腹膜关闭方式的临床疗效。方法本研究分析2016年1月-2018年8月来我院治疗的60例腹股沟疝患者临床资料,患者均行TAPP手术,按照腹膜关闭方法的不同分为可吸收线缝合组,倒刺线缝合组,疝钉固定组。观察不同腹膜关闭方式TAPP手术的出血量、手术时间,住院时间,住院费用,术后24小时急性疼痛评分,并发症的发生率。结果三组患者手术的出血量、住院时间、术后24小时急性疼痛评分(visual analogue scale,VAS)、并发症的发生率均无统计学差异(P>0.05),疝钉固定组手术时间短于另外两组,差异有统计学意义(P<0.05),疝钉固定组及倒刺线缝合组住院费用明显高于可吸收线缝合组,差异有统计学意义(P<0.05)。结论TAPP不同腹膜关闭方式的临床疗效无明显差异,手术医师可根据经验及患者情况选择合适腹膜闭合方式。

Objective To explore the clinical effect of different peritoneal closure in transabdominal preperitoneal hernia repair. Methods In this study, clinical data of 60 patients with inguinal hernia who were treated in our hospital from January 2016 to August 2018 were analyzed. All patients underwent TAPP surgery. According to different methods of peritoneal closure, they were divided into absorbable suture group, barb suture group and hernia screw fixation group. Blood loss, operation time, length of stay, hospital costs, acute pain score 24 hours after operation and incidence of complications were observed. Results Of three groups of patients with blood loss, hospital stay, acute pain score of postoperative 24 hours, the incidence of complications were no statistical difference(P > 0.05), operation time of hernia screw fixation group was shorter than the other two groups, the difference was statistically significant(P < 0.05), hospital costs of hernia screw fixation group and barb suture group was obviously higher than absorbable suture group, the difference was statistically significant(P < 0.05). Conclusion There was no significant difference in the clinical efficacy of different methods of peritoneal closure in TAPP, and surgeons could choose the appropriate method of peritoneal closure according to their experience and the patient’s situation.