开放手术辅助腹腔镜与完全腹腔镜下修补术治疗腹壁切口疝的临床研究

Clinical study of open surgery assisted laparoscopy and complete laparoscopic repair in the treatment of abdominal incisional hernia

目的探讨分析开放手术辅助腹腔镜与完全腹腔镜下修补术治疗腹壁切口疝的临床疗效和应用。方法回顾性分析2016年1月至2018年6月在首都医科大学附属北京潞河医院普外科就诊并进行手术治疗的41例腹壁切口疝患者的临床资料。按照随机数字法表随机分为观察组和对照组。其中观察组20例,行开放手术辅助腹腔镜疝修补术;对照组21例,行完全腹腔镜下疝修补术。比较2组患者手术情况以及术后恢复、随访并发症情况。应用SPSS 21.0统计学软件进行数据处理。结果观察组患者手术时间(106.81±33.90)min,术中出血量(14.05±7.85)ml,并发症发生1例(5%);对照组分别为(126.75±23.36)min,(27.25±15)ml,3例(14.29%),差异有统计学意义(P均<0.05)。观察组术后排气时间(2.05±0.51)d、住院天数(6.95±2.31)d,对照组分别为(1.71±0.64)d、(6.38±1.24)d,差异均无统计学意义(P均>0.05)。结论开放手术辅助腹腔镜修补术治疗腹壁切口疝可明显缩短手术时间,减少术中出血,减少术后并发症的发生,效果显著,是一种安全有效的治疗方法。

Objective To explore the clinical experience and application of open surgery assisted laparoscopy and complete laparoscopic repair in the treatment of abdominal incisional hernia.Methods A retrospective review of 41 patients with abdominal incisional hernia who were treated in Beijing Luhe hospital from January 2016 to June 2018 was carried out.Among them,20 cases were treated with open surgery assisted laparoscopic repair as observation group,and 21 cases were treated with complete laparoscopic repair as control group.The surgical indexes,postoperative recovery,follow-up complications of the two groups were compared.Results The operation time of the observation group was(106.81±33.90)min,the intraoperative blood loss was(14.05±7.85)ml,and the complications occurred in 1 case(5%);the control group was(126.75±23.36)min,(27.25±15)ml,and 3 cases(14.29%),respectively.There was no significant difference between the two groups(P<0.05).The postoperative exhaust time was(2.05±0.51)d and hospitalization days was(6.95±2.31)d in the observation group,and they were(1.71±0.64)d and(6.38±1.24)d in the control group respectively,and there was no statistically significant difference(P>0.05).Conclusion Open surgery assisted laparoscopic repair of abdominal incisional hernia can significantly shorten the operation time,reduce intraoperative bleeding volume,and reduce the occurrence of postoperative complications,and it has good safety,with high clinical value.