急诊腹腔镜经腹腔腹膜前修补术治疗成人嵌顿疝的临床疗效

Clinical efficacy analysis of emergency laparoscopic transabdominal preperitoneal hernia repairs in the treatment of adult incarcerated hernia

目的:探讨急诊腹腔镜经腹腔腹膜前修补术(TAPP)治疗成人腹股沟嵌顿疝的临床疗效及可行性。方法:回顾性分析2018年4月至2020年12月蕲春县人民医院普外科因腹股沟嵌顿疝急诊手术患者,TAPP组41例行TAPP,对照组39例行开放疝无张力修补术(Lichtenstein),观察两组患者术中出血量、手术时间、术后排气排便时间、住院天数、住院总费用、术后并发症(切口感染、皮下积液、血清肿、慢性疼痛等)发生率及术后复发率。结果:TAPP组相比对照组手术时间及术后复发率方面差异无统计学意义,但术中出血量更少、术后排气排便时间更快、住院天数更少、术后并发症发生率更低,差异有统计学意义(P<0.05)。结论:急诊TAPP具有创伤小、术后恢复快、住院时间短、术后并发症少等优势,其治疗成人腹股沟嵌顿疝是安全、有效、可行的。

Objective:To investigate the clinical efficacy and feasibility of emergency laparoscopic transabdominal preperitoneal(TAPP)hernia repairs in the treatment of adult incarcerated inguinal hernia.Methods:The emergency operation patients with incarcerated inguinal hernia in the Department of General Surgery of Qichun People’s Hospital,Hubei,China,from April 2018 to December 2020were retrospectively analyzed.A total of 41 patients in TAPP group underwent laparoscopic TAPP hernia repairs and 39 patients in control group underwent open hernia tension-free repair(Lichtenstein).The amount of intraoperative bleeding,operation time,postoperative exhaust and defecation time,length of hospital stay,total hospitalization cost,incidence of postoperative complications(incision infection,subcutaneous effusion,seroma,chronic pain,etc.)and postoperative recovery were observed.Results:There was no significant difference in operation time and postoperative recurrence rate between TAPP group and control group.However,in TAPP group,the amount of intraoperative bleeding was less,the postoperative exhaust and defecation time was faster,the hospital stay was shorter,and the incidence of postoperative complications was lower,with statistically significant difference(P<0.05).Conclusion:Emergency laparoscopic TAPP hernia repairs has the advantages of less trauma,rapid postoperative recovery,short hospital stay and less postoperative complications.It is safe,effective and feasible to treat adult inguinal incarcerated hernia.