腹腔镜完全腹膜外疝修补术与李金斯坦手术对男性性功能与睾丸功能的影响

The influence of TEP and Leekinstein surgery on male sexual function and testicular function

目的探讨腹腔镜完全腹膜外疝修补术(TEP)和李金斯坦术治疗腹股沟疝对性功能和睾丸的影响。方法回顾性分析2018年2月至2020年12月池州市人民医院诊治的100例腹股沟疝患者临床资料,按照手术方法不同分为观察组(n=52)与对照组(n=48),分别予以TEP和李金斯坦术式。比较2组患者的术中出血量、手术时间、下床活动时间、住院时间以及术前、术后1个月的酸性磷酸酶(ACP)、果糖、α-葡萄糖苷酶(α-Glu)、睾丸阻力、睾丸体积、睾丸动脉管径、并发症情况及复发率。结果观察组的术中出血量低于对照组[(15.16±2.36)mL vs.(24.33±5.42)mL],手术时间长于对照组[(67.76±8.65)min vs.(54.33±6.01)min],住院时间短于对照组[(6.11±1.32)d vs.(7.54±1.42)d],差异均有统计学意义(P<0.05);2组患者下床活动时间比较,差异无统计学意义(P>0.05)。术前,2组患者的ACP、果糖、α-Glu、睾丸阻力、睾丸体积、睾丸动脉管径比较,差异无统计学意义(P>0.05);术后1个月,观察组患者的ACP、果糖、α-Glu为(187.49±18.49)U/mL、(3.45±0.94)g/L、(62.98±5.19)U/mL,明显高于对照组[(160.32±16.45)U/mL、(2.37±0.52)g/L、(46.77±3.52)U/mL],差异均有统计学意义(P<0.05),而2组的睾丸阻力、睾丸体积、睾丸动脉管径比较,差异无统计学意义(P>0.05)。观察组患者并发症总发生率(3.85%)明显低于对照组(25.00%),差异有统计学意义(P<0.05);观察组复发率(0)低于对照组(6.25%),但差异无统计学意义(P>0.05)。结论TEP与李金斯坦手术相比,前者治疗腹股沟疝对性功能影响更小,并发症发生率更低,复发率更低。

Objective To investigate the effects of laparoscopic total extraperitoneal hernia repair(TEP)and Lichtenstein's surgery for inguinal hernia on sexual function and testis.Methods The clinical data of 100 patients with inguinal hernia diagnosed and treated by Chizhou People's Hospital from February 2018 to December 2020 were retrospectively analyzed.They were divided into observation group(n=52)and control group(n=48)according to different surgical methods,TEP and Li Kinstein's procedure were given respectively.Intraoperative blood loss,operation time,time to get out of bed,hospitalization time,acid phosphatase(ACP),fructose,α-glucosidase(α-Glu),testicular resistance,testicular volume,testicular artery diameter,complications and recurrence rates of the two groups were compared.Results The intraoperative blood loss in the observation group was lower than that in the control group[(15.16±2.36)mL vs.(24.33±5.42)mL],and the operation time was longer than that in the control group[(67.76±8.65)min vs.(54.33±6.01)min],the length of hospital stay was shorter than that in the control group[(6.11±1.32)d vs.(7.54±1.42)d],the differences were statistically significant(P<0.05);the comparison of the time of getting out of bed between the two groups was not statistically significant(P>0.05).Before operation,there was no significant difference in ACP,fructose,α-Glu,testicular resistance,testicular volume,and testicular artery diameter between the two groups of patients(P>0.05).After 1 month operation,the levels of ACP,fructose andα-Glu in the observation group were(187.49±18.49)U/mL,(3.45±0.94)g/L,and(62.98±5.19)U/mL,which were significantly higher than those in the control group[(160.32±16.45)U/mL,(2.37±0.52)g/L,(46.77±3.52)U/mL],the differences were statistically significant(P<0.05),while there was no significant difference in testicular resistance,testicular volume,and testicular artery diameter between the two groups(P>0.05).The total incidence of complications in the observation group(3.85%)was significantly lower than that in the control group(25.00%),and the difference was statistically significant(P<0.05);the recurrence rate in the observation group(0)was lower than that in the control group(6.25%),but the difference was not statistically significant(P>0.05).Conclusion Compared with Lee Kinstein's operation,TEP has less effect on sexual function,lower complication rate,and lower recurrence rate in the treatment of inguinal hernia.