自固定补片与聚丙烯补片在腹腔镜经腹腹膜前疝修补术中的应用效果比较

Application effect analysis of self-fixation mesh and polypropylene mesh in laparoscopic transabdominal preperitioneal laparoscopie herniorrhaphy

目的比较自固定补片与聚丙烯补片在腹腔镜经腹腹膜前疝修补术(TAPP)中的应用效果。方法收集2016年2月至2020年2月于中南大学湘雅二医院治疗腹股沟疝的164例患者的临床资料。按照TAPP术中使用补片不同分为试验组和对照组,各82例。试验组术中应用自固定补片,对照组术中应用聚丙烯补片,2组均平均随访1年。比较2组手术临床指标及术后并发症的发生率。结果试验组补片放置时间明显长于对照组(P<0.05),且试验组手术时间明显长于对照组(P<0.05),试验组花费高于对照组(P<0.05)。2组患者的术后的住院时间、术中并发症的发生率差异无统计学意义(P>0.05)。2组术后1 d至3个月视觉模拟评分量表(VAS)的评分均呈下降趋势,差异有统计学意义(P<0.05),且术后各个随访时间点试验组VAS评分低于对照组,差异有统计学意义(P<0.05)。试验组总并发症的发生率(24.39%)低于对照组(32.93%),异物感(1.22%)低于对照组(4.88%),差异均无统计学意义;2组在随访期内均未的复发。结论TAPP术中应用自固定补片较聚丙烯补片增加了患者的经济费用,但利于其术后恢复,疼痛较轻,且未增加术后复发的风险。

Objective To compare the application effect of self-fixation mesh and polypropylene mesh in laparoscopic transabdominal preperitioneal laparoscopie herniorrhaphy(TAPP).Methods The clinical data of 164 patients with inguinal hernia admitted to our hospital from Febuary 2016 to Febuary 2020 were retrospectively analyzed,and they were divided into the experiment group and the control group according to different intraoperative mesh,with 82 cases in each group.The 2 group all underwent TAPP operation,the experiment group used self-fixation mesh in the operation,and the control group used polypropylene mesh in the operation,both groups were followed up for an average of one year.The clinical indicators and the incidence of postoperative complications of the two groups were compared between the two groups.Results In terms of surgical indicators,the patch placement time of the experimental group was significantly longer than that of the control group(P<0.05),and the operation time of the experimental group was significantly longer than that of the control group(P<0.05),and the cost of the experimental group was significantly higher than that of the control group(P<0.05).There was no statistical significance in the postoperative hospital stay and incidence of intraoperative complications between the two groups(P>0.05).The VAS scores of the two groups showed a downward trend from 1 day to 3 months after operation(P<0.05),and the experiment group was significantly lower than the control group at each time point after operation(P<0.05).The incidence of total complications in the experimental group was not significantly different from that in the control group(24.39%vs 32.93%),but the incidence of foreign body sensation in the experimental group was significantly lower than that in the control group(1.22%vs 4.88%).No recurrence occurred in the two groups during the follow-up period.Conclusion Compared with polypropylene mesh,the application of TAPP intraoperative self-fixation mesh increases the cost of patients,but is beneficial to the postoperative recovery of patients with inguinal hernia,with less pain and no increased risk of postoperative recurrence.