基层医院开展TAPP与Lichtenstein手术的疗效比较

Transabdominal preperitoneal prosthetic versus Lichtenstein's method for inguinal hernia repair in primary hospitals:a comparison of therapeutic effect

目的:比较基层医院开展经腹腔途径腹膜前补片植入术(TAPP)与前入路腹股沟疝后壁修补术(Lichtenstein's method)的临床疗效。方法:回顾性分析本院2017年10月至2019年1月收治的138例成人腹股沟疝患者的临床资料,其中TAPP 70例,Lichtenstein术68例,比较两组术中及术后相关指标。结果:两组均成功完成手术。两组手术时间、术中出血量及术后首次下床活动时间的差异无统计学意义(P>0.05);TAPP组术中发现隐匿疝多于Lichtenstein组(P<0.05),术后住院时间显著短于Lichtenstein组(P<0.01),术后异物感、术后慢性疼痛发生率低于Lichtenstein组(P<0.05)。结论:相较于Lichtenstein手术,TAPP更易发现隐匿疝,术后恢复快、并发症发生率低、住院时间短,是基层医院可行的腹股沟疝修补术式。

Objective:To compare the therapeutic effect of laparoscopic transabdominal preperitoneal prosthetic(TAPP)approach and Lichtenstein's method for inguinal hernia repair in primary hospitals.Methods:The clinical data of 138 adults with inguinal hernia admitted in our hospital from October 2017 to January 2019 were analyzed retrospectively.Of them,70 cases underwent TAPP and 68 cases underwent Lichtenstein's method.The relevant intraoperative and postoperative indexes were compared between the two groups.Results:The operation was successfully completed in both groups.There were no significant differences between the two groups in operation time,intraoperative bleeding volume and the time of first getting out of bed after operation(P>0.05).The occult hernia in TAPP group was more than that in Lichtenstein group(P<0.05),the postoperative hospital stay was significantly shorter than that in Lichtenstein group(P<0.01),and the incidence of foreign body sensation and postoperative chronic pain was lower than that in Lichtenstein group(P<0.05).Conclusion:Compared with Lichtenstein's method,TAPP approach is easy to find hidden hernia with fast postoperative recovery,low complication rate and short hospital stay.It is a feasible method for inguinal hernia repair in primary hospitals.