疝囊横断与完全剥离对男性腹股沟疝预后的影响分析

Clinical Effects of Hernia Sac Dissection or Transection on Male Inguinal Hernia

目的对比分析横断与完全剥离在腹腔镜腹膜前间隙疝修补术中的应用效果及对预后的影响,为腹股沟疝的治疗提供科学依据.方法本研究选取2016年9月—2018年10月间在本院接受TAPP治疗的134例老年男性腹股沟疝患者作为研究对象.在患者知情同意的前提下,采用随机数字表法将所有研究对象随机分为完全剥离组与疝囊横断组,每组67例.对比分析两组的治疗效果和预后情况.结果完全剥离组和横断组在手术时间、术中出血量和住院时间相当,两组在3个指标间差异均无统计学意义(P>0.05).完全剥离组患者的并发症总发生率为10.45%;横断组患者总发生率为23.88%.χ2检验显示,两组并发症发生率比较差异具有统计学意义(χ2=4.663,P=0.031).完全剥离组患者的2周恢复率明显优于横断组,差异具有统计学意义(χ2=5.858,P=0.016).结论对于老年男性腹股沟疝患者,疝囊完全剥离和横断旷置两种方法均安全、可靠,然而疝囊完全剥离术后并发症的总体发生率更低,短期的恢复效果更好.

Objective To compare the effects and prognosis of hernia sac dissection or transection in laparoscopic anterior sacral hernia repair,aimed at providing scientific basis for the treatment of inguinal hernia.Methods A total of 134 elderly male inguinal hernia patients underwent TAPP treatment from September 2016 to October 2018 were enrolled in this study.All subjects were randomly divided into dissection and transection group by random number table on the premise of informed consent of patients,67 cases in each group.The clinical effects and prognosis of the two groups were compared and analyzed.Results The operation time,intraoperative blood loss and hospitalization time were comparable between two groups.There was no significant difference between two groups(P>0.05).The total incidence of complications was 10.45%and 23.88%,respectively.Theχ2 test showed a statistically significant difference in the incidence of complications between the two groups(χ2=4.663,P=0.031).The 2-week recovery rate was significantly higher in the complete dissection group than transection group(χ2=5.858,P=0.016).Conclusion Both hernia sac dissection and transection are safe and reliable for elderly male inguinal hernia patients.Besides,Patients in complete dissection group had lower complications incidence and better short-term recovery.