腹腔镜下完全腹膜外疝修补术治疗原发性腹壁疝的效果

Efficacy of laparoscopic totally extraperitoneal prosthesis on primary abdominal wall hernia

目的探讨腹腔镜下完全腹膜外疝修补术(TEP)治疗原发性腹壁疝的效果。方法抽取焦作市人民医院2016年1月至2018年12月收治的78例符合条件的原发性腹壁疝患者作为研究对象,按随机数字表法分为观察组和对照组,每组39例。观察组接受TEP治疗,对照组接受腹腔镜经腹膜前疝修补术(TAPP)治疗。评估两组疗效,记录围术期指标,比较两组并发症,包括神经痛、尿储留、肠梗阻、切口感染;随访12个月,记录两组术后复发情况。结果两组治疗总有效率比较,差异未见统计学意义(P>0.05);观察组补片放置时间及术后抗生素使用时间短于对照组(P<0.05);两组术后胃肠功能恢复时间及医疗费用比较,差异未见统计学意义(P>0.05);两组并发症发生率比较,差异未见统计学意义(P>0.05);随访12个月,两组均无复发。结论TEP与TAPP均对原发性腹壁疝的治疗有一定价值,疗效确切,患者术后并发症及复发风均险低,而TEP可缩短术中补片放置时间及术后抗生素使用时间,减少医疗费用。

Objective To investigate the benefit of laparoscopic totally extraperitoneal prosthesis(TEP)in the treatment of primary abdominal wall hernia.Methods Seventy-eight eligible patients with primary abdominal wall hernia treated in Jiaozuo People’s Hospital from January 2016 to December 2018 were selected as the research subjects,they were divided into observation group and control group by random number table method,with 39 cases in each group.The observation group received TEP treatment,while the control group received laparoscopic tansabdominal preperitoneal prosthesis(TAPP).The curative effect of the two groups was evaluated,the perioperative indexes were recorded,the complications,including neuralgia,urinary retention,intestinal obstruction and wound infection,were compared between the two groups;after 12 months of follow-up,their postoperative recurrence was recorded.Results There was no significant difference in the total effective rate between the two groups(P>0.05);the patch placement time and postoperative antibiotic use time of the observation group were shorter than those of the control group(P<0.05);there was no significant difference in postoperative gastrointestinal function recovery time and medical expenses between the two groups(P>0.05);there was no significant difference in the incidence of complications between the two groups(P>0.05);followed up for 12 months,there was no recurrence in both groups.Conclusions TEP and TAPP have certain value in the treatment of primary abdominal wall hernia,with definite curative effect and low risk of postoperative complications and recurrence.TEP can shorten the time of patch placement and postoperative antibiotic use,and reduce medical costs.