腹腔镜手术同时治疗腹股沟疝与精索静脉曲张的可行性研究

Feasibility of laparoscopic surgery for inguinal hernia and varicocele

目的探讨腹腔镜手术同时治疗腹股沟疝与精索静脉曲张的可行性及预防其并发症发生的有效方法。方法选取宜昌市第二人民医院2014年1月至2018年12月共86例腹腔镜下同时行腹股沟疝修补术(TAPP)与精索静脉曲张手术的患者作为观察组,选取同时段96例分期行TAPP和精索静脉曲张手术的患者作为对照组,比较2组患者的手术时间、住院时间、住院费用、术中出血量、并发症发生率、复发率及患者满意度。结果观察组患者手术时间(45.5±12.8)min,住院时间(3±0.3)d,住院费用(3856±132.5)元;对照组患者手术时间(79.2±10.3)min,住院时间(5±0.7)d,住院费用(6018±743.6)元,2组比较差异均有统计学意义(P<0.05)。患者术中出血量比较,2组差异无统计学意义(P>0.05)。观察组慢性疼痛发生率低于对照组,差异有统计学意义(P<0.05);其余并发症发生率比较,2组差异无统计学意义(P>0.05)。术后随访3~18个月,2组满意度比较差异无统计学意义(P>0.05)。结论同时行腹股沟疝与精索静脉曲张腹腔镜手术安全可靠,有利于缩短患者住院时间,减少住院费用,具有较好的临床效果。

Objective To explore the feasibility of laparoscopic surgery in the treatment of inguinal hernia and varicocele at the same time and the effective method to prevent its complications. Methods From January 2014 to December 2018,a total of 86 patients of inguinal hernia and varicocele treated with transabdominal preperitoneal( TAPP) and high ligation of varicocele under laparoscopy in the second people’s hospital of Yichang city were selected as the observation group,and 96 patients of inguinal hernia and varicocele treated with transabdominal preperitoneal and high ligation of varicocele under laparoscopy by stages were selected as the control group during the same period.The operation time,hospitalization time,hospitalization cost,intraoperative blood loss,complication rate,recurrence rate and patients’ satisfaction were compared between the two groups. Results In the observation group,the operation time was( 45. 5 ± 12. 8) minutes,the hospitalization time was( 3 ± 0. 3) days,and the hospitalization cost was( 3 856 ± 132. 5) yuan;In the control group,the operation time was( 79. 2 ± 10. 3) minutes,the hospitalization time was( 5 ± 0. 7) days,and the hospitalization cost was( 6 018 ± 743. 6) yuan,there were significant differences in the above indicators between two groups( P < 0. 05). There was no significant difference in the amount of bleeding between the two groups( P > 0. 05). The incidence of chronic pain in the observation group was lower than that in the control group,the difference was significant( P < 0. 05). And there was no significant difference in other complications between the two groups( P > 0. 05). After followed up for 3 to 18 months,there was no significant difference in satisfaction between the two groups( P > 0. 05). Conclusion Laparoscopic surgery for inguinal hernia and varicocele at the same time is safe and reliable,which is beneficial to shorten the length of hospitalization stay and reduce the cost of hospitalization,and it has good clinical effect.