腹腔镜下腹股沟疝修补（TAPP）与传统无张力腹股沟疝修补术的临床对比研究

Clinical comparative study of laparoscopic repair of inguinal hernia(TAPP)and traditional tension-free inguinal hernia repair

目的对比研究腹腔镜下腹股沟疝修补(TAPP)与传统无张力疝修补术在腹股沟疝临床治疗中的应用价值。方法将我院2017年3月~2018年3月收治的94例腹股沟疝患者随机分为观察组和对照组(n=47),对照组患者行传统无张力腹股沟疝修补术治疗,观察组患者行TAPP术治疗。观察并统计两组患者的手术治疗指标、术后并发症的发生率、术后复发率和对侧隐匿疝发现率。结果观察组平均术中出血量少于对照组(P<0.05);观察组术后疼痛持续时间、下床活动时间及住院时间均短于对照组(P<0.05)。观察组术后并发症总发生率和对照组依次为10.65%、27.66%,两组比较,差异均有统计学意义(P<0.05)。观察组术后复发率为2.13%,对照组为6.38%,两组差异无统计学意义(P>0.05)。观察组对侧隐匿疝发现率为100%,对照组为0,两组比较,差异具有统计学意义(P<0.05)。结论在腹股沟疝的临床治疗中相较于传统无张力腹股沟疝修补术,TAPP术在减轻手术创伤、降低术后并发症发生率、降低术后复发率、发现对侧隐匿疝及对无张力修补后的复发疝再次手术均具有良好的优势,值得临床推广应用。

Objective To compare the application value of laparoscopic repair of inguinal hernia(TAPP) and traditional tension-free hernia repair in the clinical treatment of inguinal hernia. Methods A total of 94 patients with inguinal hernia admitted to our hospital from March 2017 to March 2018 were randomly divided into the observation group and the control group(n=47 in both groups). The control group was treated with conventional tension-free inguinal hernia repair and the observation group was treated with TAPP. The surgical treatment indicators, incidences of postoperative complications, postoperative recurrence rates and detection rates of contralateral concealed hernia of the two groups were observed and analyzed. Results The observation group was less than the control group in the mean intraoperative blood loss amount(P<0.05). The observation group was shorter than the control group in the duration of postoperative pain, time to get out of bed and hospitalization time(P<0.05). The total incidences of postoperative complications in the observation group and the control group were 10.65% and 27.66%, respectively, with statistically significant difference between the two groups(P<0.05). The recurrence rate was 2.13% in the observation group and 6.38% in the control group, with no statistically significant difference between the two groups(P>0.05). The detection rate of contralateral concealed hernia was 100% in the observation group and 0 in the control group, with statistically significant difference between the two groups(P<0.05). Conclusion In the clinical treatment of inguinal hernia, compared with traditional tensionfree inguinal hernia repair, TAPP has good advantages in reducing the surgical trauma, reducing the incidence of postoperative complications, reducing the recurrence rate, finding contralateral concealed hernia and reoperation of relapsed hernia after tension-free repair, which is worthy of clinical application.