腹腔镜经腹膜前疝补片植入修补术治疗235例单侧腹股沟疝疗效观察

Clinical observation of 235 patients with unilateral inguinal hernia undergoing laparoscopic transabdominal preperitoneal prosthetic herniorrhaphy

目的观察腹腔镜经腹膜前疝补片植入修补术治疗235例单侧腹股沟疝的临床疗效。方法选择2016年3月—2020年2月期间收治的470例单侧腹股沟疝患者,按治疗方式不同分为腹腔镜经腹膜前疝前补片植入修补术(观察组)和开放式无张力腹股沟疝修补术(对照组)2组,每组各235例,观察2组手术情况、术后复发与并发症、GQOL-74评分。结果2组术前VAS、GQOL-74评分无差异;观察组住院时间[(5.45±0.85)d对(8.25±1.55)d]、术后VAS评分(2.54±0.54对5.25±1.05)、下床活动时间[(13.52±3.54)h对(45.42±4.02)h]、术后并发症发生率(3.40%对13.19%)和术后6个月复发率(2.55%对9.36%)均低于对照组(均P<0.05),但手术时间(73.42±4.36)min对(44.52±4.42)min、术后GQOL-74评分却高于对照组(均P<0.05)。结论腹腔镜下经腹膜前疝补片植入修补术治疗单侧腹股沟疝,术后生活质量较高,患者疼痛较少,住院时间较短、复发率与并发症较少,值得应用。

Objective To observe the clinical efficacy of laparoscopic transabdominal preperitoneal prosthetic herniorraphy on unilateral inguinal hernia among 235 patients.Methods A total of 470 patients with unilateral inguinal hernia treated from March 2016 to February 2020 in our hospital were divided into a laparoscopic transabdominal preperitoneal prosthetic herniorraphy group(observation group)and an open tension-free inguinal hernia repair group(control group)according to different therapies,with 235 cases in each group.Operation conditions,postoperative recurrence rate and complications,and GQOL-74(Generic Quality of Life Inventory-74)scores of the two groups were evaluated.Results No differences in preoperative VAS(Visual Analogue Scale)and GQOL-74 scores were observed between the two groups.The length of hospital stay[(5.45±0.85)d vs.(8.25±1.55)d],postoperative VAS scores(2.54±0.54 vs.5.25±1.05),time of off⁃bed activity[(13.52±3.54)h vs.(45.42±4.02)h],postoperative complication rate(3.40%vs.13.19%),and recurrence rate at 6 months after surgery(2.55%vs.9.36%)in the observation group were all lower than those in the control group(all P<0.05),but the operative time[(73.42±4.36)min vs.(44.52±4.42)min]and postoperative GQOL-74 score were higher than those in the control group(all P<0.05).Conclusion Laparoscopic transabdominal preperitoneal prosthetic herniorraphy for unilateral inguinal hernia can produce higher life quality,less postoperational pain,shorter hospital stay,a lower recurrence rate,and fewer complications,thus it is worthy of application.