两种圆韧带保留方式在女性腹腔镜腹股沟疝修补术中的应用

Application of two methods of round ligament reservation in laparoscopic inguinal hernia repair in women

目的探讨比较女性腹腔镜腹股沟疝修补术中两种圆韧带保留方式的安全性和疗效差异。方法回顾性收集本院2012年1月至2019年1月行腹股沟疝修补术的患者,筛选行腹腔镜腹股沟疝修补术中保留子宫圆韧带的女性患者,排除年龄<18岁,嵌顿疝,复发疝。分析比较两种保留圆韧带方式在手术时间、出血量、术后住院时间、术后疼痛、术后复发及其他术后并发症的差异。结果腹膜切开缝合组术后复发率为4.3%,Keyhole组为0%,两组复发率比较差异无统计学意义,总体的复发率为2.3%,术中及术后无感染、出血等严重并发症。在手术时间、出血量、术后住院时间、血清肿、麻木感、术后疼痛、慢性疼痛方面二者差异无统计学意义。结论腹膜切开缝合法和Keyhole法均为女性腹腔镜腹股沟疝术中保留圆韧带的安全有效的方法,二者在疗效及并发症上无明显差异。

Objective The aim of this study is to compare the safety and efficacy of laparoscopic groin hernia repair with two methods for the preservation of round ligament in female patients.Methods This study retrospectively researched the female consecutive patients undergoing laparoscoic groin hernia repair from January 2012 to January 2019 at our hernia surgery center,recurrent hernia and incarcerated hernia and age less than 18 were excluded.The difference of operation time,blood loss,postoperative hospitalization time,postoperative pain,postoperative recurrence and other postoperative complications between the two methods were analyzed and compared.Results The postoperative recurrence rate in the peritoneal incision and suture group was 4.3%,and that in the Keyhole group was 0%.There was no statistical difference in the recurrence rate between the two groups,and the overall recurrence rate was 2.3%.No infection,bleeding and other serious complications occurred during and after operation.There was no significant difference in operative time,blood loss,postoperative hospital stay,seroma,numbness,postoperative pain and chronic pain.Conclusion Peritoneotomy and Keyhole method are both safe and effective methods for the preservation of round ligament in female laparoscopic groin hernia surgery,and there is no significant difference in efficacy and complications between the two methods.