腹腔镜经腹腹膜前疝修补术和腹腔镜完全腹膜外疝修补术治疗成人腹股沟疝的疗效

Comparative study on clinical efficacy and safety of laparoscopic TAPP and TEP in the treatment of adult inguinal hernia

目的探讨腹腔镜经腹腹膜前疝修补术(TAPP)和腹腔镜完全腹膜外疝修补术(TEP)治疗成人腹股沟疝的临床疗效及安全性对比研究。方法选取2016年3月至2019年3月入住南京市栖霞区医院的成人腹股沟疝患者320例,按治疗方式分为TAPP及TEP组,各160例。比较2组手术时长及临床效果、出现并发症和复发的概率、心理状态。结果TAPP组与TEP组双侧疝手术时长、单侧疝手术时长、疼痛持续时长、肛门排气时间无差异,但TAPP组住院时长短于TEP组(P<0.05);TAPP组和TEP组并发症及复发率比较,差异均无统计学意义(P>0.05);治疗后TEP组心理状态明显优于TAPP组(P<0.05)。结论在治疗成人腹股沟疝患者的过程中,腹腔镜TAPP及TEP术式疗效显著且具有较高安全性,值得在临床推广应用。

Objective To explore the clinical efficacy and safety of laparoscopic trans-abdominal preperitoneal hernia repair(TAPP)and laparoscopic totally extra-peritoneal hernia repair(TEP)hernia repair in the treatment of adult inguinal hernia.Methods A total of 320 adult patients with inguinal hernia who were admitted to Nanjing Qixia District Hospital from March 2016 to March 2019 were selected and divided into TAPP group and TEP group according to treatment methods,with 160 cases in each group.The operation time and clinical effect,the incidence of complications and recurrence,and the psychological status of the two groups were compared.Results There were no differences in the operation time of bilateral hernias,the operation time of unilateral hernia,the duration of pain,and the time of anal exhaustion between the TAPP group and TEP group(P>0.05),but the hospitalization length of the TAPP group was lower than that of the TEP group(P<0.05);There was no difference in the incidence of complications between the TAPP group and TEP group(P>0.05),but the recurrence rate of the TEP group was lower than that of the TAPP group(P<0.05);The mental state of the TEP group after treatment was significantly better than that of the TAPP group(P<0.05).Conclusion In the treatment of adult patients with inguinal hernia,laparoscopic TAPP and TEP have high safety and significant therapeutic effect,which is worthy of extensive clinical application and promotion.