摘要
目的探讨层面解剖技术完全腹膜外腹腔镜疝修补术(TEP)治疗成人腹股沟疝的临床效果。方法44例行腹腔镜疝修补的成人腹股沟疝患者为研究对象,根据手术方式不同将患者分为观察组及对照组,各22例。对照组患者应用常规TEP治疗,观察组患者采用层面解剖技术进行TEP治疗。统计患者复发情况、中转手术情况,比较两组患者术中出血量、手术时间、术后下床活动时间、住院天数及术中并发症发生率。结果对44例患者平均随访7个月,无复发病例。对照组中转行腹腔镜经腹腹膜前疝修补术(TAPP)3例,观察组无中转手术情况。观察组患者手术时间(55±5)min短于对照组的(75±15)min,术中出血量(10±5)ml少于对照组的(15±7)ml,差异有统计学意义(P<0.05)。观察组患者术后下床活动时间(1.2±0.4)d、住院天数(4±1)d均短于对照组的(2.1±0.7)、(6±1)d,差异有统计学意义(P<0.05)。观察组患者术中并发症发生率9.1%低于对照组的40.9%,差异有统计学意义(P<0.05)。结论层面解剖技术TEP治疗成人腹股沟疝疗效显著,可明显缩短手术时间及住院时间,减少术中出血量,且术中并发症少。
Objective To discuss the clinical effect of section anatomy of laparoscopic totally extraperitoneal prosthesis(TEP)on adult inguinal hernia.Methods A total of 44 adult patients with inguinal hernia as study subjects were divided into observation group and control group by different surgical methods,with 22 cases in each group.The control group was treated by routine TEP,and the observation group was treated by section anatomy of TEP.The recurrence and surgery-conversion status was counted.The amount of intraoperative hemorrhage,surgery time,off-bed activity time after surgery,hospitalization time and incidence of complications during surgery were compared between the two groups.Results 44 patients were followed up for an average of 7 months with no recurrence.3 cases were converted to transabdominal preperitoneal prosthesis(TAPP)in the control group,and no surgery-conversion in the observation group.The surgery time(55±5)min of the observation group was shorter than that of the control group(75±15)min,and amount of intraoperative hemorrhage during surgery(10±5)ml was less than that of the control group(15±7)ml,and the difference was statistically significant(P<0.05).The off-bed activity time after surgery(1.2±0.4)d and hospitalization time(4±1)d of the observation group was shorter than that of the control group(2.1±0.7)and(6±1)d,and the difference was statistically significant(P<0.05).The incidence of complications during surgery 9.1%of the observation group was lower than that of the control group 40.9%,and the difference was statistically significant(P<0.05).Conclusion Section anatomy of laparoscopic totally extraperitoneal prosthesis shows remarkable efficacy on adult inguinal hernia,which can obviously shorten surgery time and hospitalization time,reduce amount of intraoperative hemorrhage during surgery,and has fewer complications during surgery.
作者
官伟军
王洪健
杨凯
侯远发
GUAN Wei-jun;WANG Hong-jian;YANG Kai(Department of Abdominal Surgery,Yunfu People's Hospital Affiliated to Nanfang Medical University,Yunfu 527300,China)
出处
《中国实用医药》
2020年第22期1-3,共3页
China Practical Medicine