腹腔镜经腹腹膜前疝修补术对成人复发性腹股沟疝的近远期疗效分析

Analysis of the Short-and Long-Term Efficacy of Laparoscopic Transabdominal Preperitoneal Hernia Repair in Adults with Recurrent Inguinal Hernia

目的:分析腹腔镜经腹腹膜前疝修补术(transabdominal preperitoneal,TAPP)对成人复发性腹股沟疝的近远期疗效。方法:本研究是一项回顾性临床研究,选取2019年1月至2020年1月期间我院收治的98例成人复发性腹股沟疝患者为研究对象,根据手术方式分为观察组(TAPP术,n=60)和对照组(开放式无张力疝修补术,n=38),比较两组患者的围手术期资料、住院天数、住院费用和术后复发状况。结果:全部患者均顺利完成手术,观察组患者的术中出血量、术后进食时间、术后首次排气时间、首次下床时间、住院天数显著低于对照组,住院费用显著高于对照组(P<0.05)。观察组、对照组各有1例患者复发,两组术后并发症和复发的发生率比较,差异无统计学意义(P>0.05)。结论:与传统开放式无张力疝修补术相比,TAPP术对成人复发性腹股沟疝的短期疗效更佳,创伤小、术后恢复快,安全性与远期疗效相当,术后复发率均较低。

Objective:To analyze the short-term and long-term curative efficacy of transabdominal preperitoneal(TAPP)for recurrent inguinal hernia in adults.Methods:This study is a retrospective clinical study,and ninety-eight adult patients with recurrent inguinal hernia treated in our hospital from January 2019 to January 2020 were enrolled in the research and divided into study group(TAPP,n=60)and control group(open tension-free hernia repair,n=38)according to the operation method.The perioperative data,hospitalization length,hospitalization expense and postoperative recurrence of the two groups were compared.Results:All patients successfully completed the operation.The amount of intraoperative bleeding,postoperative eating time,postoperative first exhaust time,first time out of bed and hospital stay in the observation group were significantly lower than those in the control group,and the hospitalization cost was significantly higher than that in the control group(P<0.05).There was one case of recurrence in the observation group and the control group respectively.There was no significant difference in the incidence of postoperative complications and recurrence between the two groups(P>0.05).Conclusion:Compared with traditional open tension-free hernioplasty,TAPP has a better short-term effect on recurrent inguinal hernia in adults,with less operative trauma,faster postoperative recovery.Their surgical safety and long-term efficacy is equivalent,and the postoperative recurrence rates were both lower.