摘要
目的 探讨经腹膜前间隙微创脐疝修补术(minimally invasive repair of umbilical hernia through preperitoneal space, MI-RUHP)与经腹膜前间隙开放脐疝修补术(open umbilical hernia repair through preperitoneal space, O-RUHP)的临床疗效。方法 选择2018年11月~2020年10月成人脐疝患者40例,按照前瞻性非随机方法分为2组,MI-RUHP和O-RUHP组各20例,2组一般资料差异无统计学意义(P>0.05)。比较2组手术时间、术后第1天疼痛视觉模拟评分(Visual Analogue Scale, VAS)、术后住院时间、住院费用、术后并发症及术后2年复发率。结果 与O-RUHP相比,MI-RUHP手术时间长[66.00(49.5~77.0)min vs. 52.30(40.3~60.8)min,Z=-4.207,P=0.000],住院费用高[10.10(9.2~10.8)千元vs. 8.10(7.2~8.6)千元,Z=-5.410,P=0.000],但术中出血量少[(10.5±2.5)ml vs.(29.3±2.3)ml,t=-24.313,P=0.000],术后疼痛轻[(2.51±0.41)分vs.(5.28±0.43)分,t=-20.727,P=0.000],住院时间短[4.0(4~5)d vs. 7.0(6~7)d,Z=-5.786,P=0.000],2组术后并发症发生率差异无统计学意义(P>0.05)。术后随访2年,MI-RUHP无复发,O-RUHP复发2例(术后第11、15个月),差异无统计学意义(P=0.487)。结论 在患者身体及经济条件允许的情况下,经腹膜前间隙微创脐疝修补术创伤小,术后恢复快,并发症少,可作为脐疝治疗的优选方案。
Objective To investigate the clinical effect of minimally invasive repair of umbilical hernia through preperitoneal space(MI-RUHP)and open umbilical hernia repair through preperitoneal space(O-RUHP).Methods A total of 40 adult patients with umbilical hernia from November 2018 to October 2020 were enrolled.A prospective non-randomized control method was used to divide the patients into two groups:MI-RUHP was performed in 20 cases and O-RUHP was performed in 20 cases.There were no significant differences in preoperative general data between the two groups(P>0.05).The operation time,Visual Analogue Scale(VAS)of pain on the first day after surgery,length of postoperative hospital stay,hospital cost,postoperative complication,and 2-year recurrence rate were compared between the two groups.Results As compared to the O-RUHP group,the MI-RUHP group had longer operation time[66.00(49.5-77.0)min vs.52.30(40.3-60.8)min,Z=-4.207,P=0.000],more expensive hospitalization expenses[10.10(9.2-10.8)×103 yuan vs.8.10(7.2-8.6)×103 yuan,Z=-5.410,P=0.000],but less intraoperative blood loss[(10.5±2.5)ml vs.(29.3±2.3)ml,t=-24.313,P=0.000],less postoperative pain[(2.51±0.41)points vs.(5.28±0.43)points,t=-20.727,P=0.000],and shorter postoperative hospital stay[4.0(4-5)d vs.7.0(6-7)d,Z=-5.786,P=0.000].The incidence of postoperative complications had no statistically significant difference between the two groups(P>0.05).After 2 years of follow-ups,there was no recurrence in the MI-RUHP group and 2 cases of recurrence in the O-RUHP group(11 and 15 months after surgery,respectively).The difference was not statistically significant(P=0.487).Conclusion If the patient’s physical and economic conditions permit,laparoscopic repair through preperitoneal space can be used as the preferred treatment for umbilical hernia,with less trauma,faster postoperative recovery,and fewer complications.
作者
康雅超
李国雷
任伊宁
刘远
兴伟
Kang Yachao;Li Guolei;Ren Yining(Department of Surgery,Hebei Hospital of Traditional Chinese Medicine,Shijiazhuang 050000,China)
出处
《中国微创外科杂志》
CSCD
北大核心
2023年第4期257-261,共5页
Chinese Journal of Minimally Invasive Surgery
关键词
脐疝
腹膜前间隙
疝修补术
微创手术
Umbilical hernia
Preperitoneal space
Hernia repair
Minimally invasive surgery