腹腔镜经腹腹膜前疝修补术日间手术模式的可行性研究

Feasibility Study on the Daytime Operation Mode of Laparoscopic Transabdominal Peritoneal Hernia Repair

目的:探讨腹腔镜经腹腹膜前疝修补术日间手术模式的可行性.方法:选取2018年1月-2019年2月本院疝外科门诊收治的拟行TAPP的患者80例.将其随机分为研究组及对照组,各40例.研究组按日间手术管理化模式,对照组按常规住院模式.比较两组术后恢复及半年内复发的情况,并比较两组并发症发生率、住院费用及患者满意度.结果:两组患者均顺利完成手术如期出院,未发生术后非计划再入院及非计划再手术.随访至术后6个月均未见复发.研究组并发症总发生率2.5%,虽低于对照组7.5%,但两组比较差异无统计学意义(P>0.05).研究组下床活动时间、住院时间均短于对照组,术后24 h疼痛评分及平均住院费用均低于对照组,差异均有统计学意义(P<0.05).研究组满意度为97.5%,高于对照组的70.0%,差异有统计学意义(P<0.05).结论:腔镜经腹腹膜前疝修补术日间手术模式安全可行,可缩短患者住院时间,减少住院费用,患者的满意度较高.

Objective:To explore the feasibility of daytime operation mode of laparoscopic transperitoneal hernia repair.Method:A total of 80 patients with TAPP who were admitted to the hernia surgery clinic of our hospital from January 2018 to February 2019 were selected.They were randomly divided into study group and control group,40 cases in each group.The study group followed the management mode of ambulatory surgery,and the control group followed the routine hospitalization mode.Postoperative recovery and recurrence within half a year were compared between the two groups,and the incidence of complications,hospitalization costs and patient satisfaction were compared between the two groups.Result:The patients in both groups successfully completed the operation and were discharged on schedule,and no postoperative unplanned readmission or unplanned reoperation occurred.No recurrence was found after 6 months of follow-up.The overall incidence of complications in the study group was 2.5%,which was lower than 7.5%in the control group,but the difference between the two groups was not statistically significant(P>0.05).The duration of getting out of bed and hospitalization in the study group were both shorter than those in the control group,and the pain score and average hospitalization cost 24 h after surgery were lower than those in the control group,with statistically significant differences(P<0.05).The satisfaction of the study group was 97.5%,higher than 70.0%of the control group,the difference was statistically significant(P<0.05).Conclusion:It is safe and feasible to use daytime operation mode of laparoscopic transperitoneal hernia repair,which can shorten the length of stay,reduce the cost of stay and improve the satisfaction of patients.