Mesh-Plug与TAPP治疗腹股沟疝的效果及对术后复发率的影响

Effect of Mesh-Plug and TAPP in the Treatment of Inguinal Hernia and Its Influence on Postoperative Recurrence Rate

目的:比较腹腔镜下经腹腹膜前疝修补术(TAPP)、疝环充填式无张力疝修补术(Mesh-Plug)治疗腹股沟疝的效果。方法:采用随机数字表法将2020年1月-2021年1月厦门大学附属第一医院收治的腹股沟疝患者80例分为对照组与观察组,各40例。对照组采用Mesh-Plug术,观察组采用TAPP术,对两组临床指标、并发症情况进行统计,术后随访1年对两组复发情况进行统计。结果:观察组住院时间、恢复活动时间、术中出血量、手术时间及术后24 h视觉模拟评分法(VAS)评分均低于对照组,治疗费用比对照组多,差异均有统计学意义(P<0.05);观察组术后并发症发生率为5.00%(2/40),低于对照组的22.50%(9/40),差异有统计学意义(P<0.05);观察组术后随访1年时的复发率为2.50%(1/40),与对照组的7.50%(3/40)比较,差异无统计学意义(P>0.05)。结论:腹股沟疝患者采用TAPP与Mesh-Plug治疗的复发率相当,但TAPP术创伤较小,可减轻术后疼痛,对患者的术后恢复有利,且安全性好。

Objective:To compare the efficacy of laparoscopic transabdominal preperitoneal hernia repair (TAPP) and hernia ring filling tension-free hernia repair (Mesh-Plug) in the treatment of inguinal hernia.Method:A total of 80 patients with inguinal hernia admitted to the First Affiliated Hospital of Xiamen University from January 2020 to January 2021 were divided into the control group and the observation group by random number table method,40 cases in each group.The control group was treated with Mesh-Plug surgery,and the observation group was treated with TAPP surgery.The clinical indicators and complications of two groups were statistically analyzed.After 1 year follow-up,the recurrence of the two groups were statistically analyzed.Result:The length of hospital stay,recovery time of activity,intraoperative blood loss,operation time and visual analogue scale (VAS) score at 24 h after operation in the observation group were lower than those in the control group,and the treatment cost was more than that in the control group,and the differences were statistically significant (P<0.05).The incidence of postoperative complications in the observation group was 5.00% (2/40),which was lower than 22.50% (9/40) in the control group (P<0.05).The recurrence rate of the observation group at 1 year of follow-up was 2.50% (1/40),the control group was 7.50% (3/40),there was no significant difference between two groups (P>0.05).Conclusion:The recurrence rate of inguinal hernia patients treated with TAPP and Mesh Plug is similar,but TAPP has less trauma,can reduce postoperative pain,is beneficial to patients’ postoperative recovery,and has good safety.