腹腔镜下全腹膜外腹股沟疝修补术与经正中线切口腹膜前腹股沟疝修补术的疗效比较

Comparison of efficacy of laparoscopic total extraperitoneal inguinal hernia repair and preperitoneal inguinal hernia repair via midline incision

目的比较腹腔镜下全腹膜外腹股沟疝修补术(TEP)与经正中线切口腹膜前腹股沟疝修补术的疗效。方法选择我院普通外科收治的128例腹股沟疝患者作为研究对象,采用随机数字法将其分为研究组(64例,TEP)和对照组(64例,经正中线切口腹膜前腹股沟疝修补术)。比较两组的手术相关指标、术后疼痛程度、生活质量、术后并发症发生情况和复发情况。结果研究组的手术时间、排气时间、下床活动时间均明显短于对照组,术中出血量明显少于对照组(P<0.05)。术后1 d及1、3个月,研究组的VAS评分均明显低于对照组(P<0.05)。术后5个月,研究组的生理、心理评分及总分均明显高于对照组(P<0.05)。研究组的术后并发症总发生率明显低于对照组(P<0.05);术后6个月,两组的复发率比较,差异不显著(P=0.40)。结论TEP与经正中线切口腹膜前腹股沟疝修补术均可有效治疗腹股沟疝患者,但TEP可明显改善患者的相关手术指标,降低术后疼痛程度、并发症发生率及复发率,提高生活质量。

Objective To compare the efficacy of laparoscopic total extraperitoneal inguinal hernia repair(TEP)and preperitoneal inguinal hernia repair viamidline incision.Methods A total of 128 patients with inguinal hernia admitted in the general surgery department of our hospital were selected as the research objects and were divided into study group(64 cases,TEP)and control group(64 cases,preperitoneal inguinal hernia repair via midline incision)by random number method.The related surgical indicators,postoperative pain,quality of life,postoperative complications and recurrence were compared between the two groups.Results The operation duration,exhaust time and out-ofbed activity time in the study group were significantly shorter than those in the control group,and the amount of intraoperative bleeding was significantly less than that in the control group(P<0.05).At 1 d,1 month and 3 month after operation,the VAS score in the study group were significantly lower than those in the control group(P<0.05).Five months after operation,the scores of physiology,psychology and total score in the study group were significantly higher than those in the control group(P<0.05).The total incidence of postoperative complications in the study group was significantly lower than that in the control group(P<0.05);six months after operation,there was no significant difference in the recurrence rate between the two groups(P=0.40).Conclusion TEP and preperitoneal inguinal hernia repair via midline incision can treat patients with inguinal hernia well,but TEP can significantly improve the related surgical indicators of patients,reduce the degree of postoperative pain,the incidence of complications and recurrence rate,and improve the quality of life.