腹腔镜下经腹腹膜前疝修补术在腹股沟疝患者中的应用研究

Study on the Application of Laparoscopic Transabdominal Preperitoneal Prosthesis in Patients with Inguinal Hernia

目的分析腹股沟疝(inguinal hernia,IH)患者应用腹腔镜下经腹腹膜前疝修补术(transabdominal preperitoneal prosthesis,TAPP)取得的效果。方法方便选取2020年1月—2021年12月东直门医院通州院区收治的88例IH患者作为研究对象,按照随机数表划分为对照组与研究组,每组44例。对照组行开放式无张力疝修补术(open tension-freerepair,OTFH),研究组行TAPP手术。针对两组术中与术后情况、疼痛情况、并发症与复发率进行比较。结果两组患者的术中操作时间对比,差异无统计学意义(P>0.05);研究组手术失血量少于对照组,差异有统计学意义(P<0.05),术后离床时间、胃肠恢复时间及住院时间较对照组短,差异有统计学意义(P<0.05)。研究组术后12 h、24 h时视觉模拟评分(VAS)均低于对照组,差异有统计学意义(P<0.05)。研究组术后并发症率4.55%低于对照组的20.45%,差异有统计学意义(χ^(2)=5.091,P<0.05),随访6个月时研究组IH复发率0.00%与对照组4.55%对比,差异无统计学意义(χ^(2)=0.512,P>0.05)。结论IH患者应用TAPP治疗能够有效减少术中失血量,缩短术后康复速度,降低并发症风险。

Objective To analyze the results achieved by applying laparoscopic transabdominal preperitoneal prosthesis(TAPP)in patients with inguinal hernia(IH).Methods From January 2020 to December 2021,88 patients with IH admitted to Tongzhou District of Dongzhimen Hospital were conveniently selected as the research objects.According to the random number table,they were divided into control group and study group,with 44 cases in each group.The control group underwent open tension-free repair(OTFH),and the study group underwent TAPP surgery.The intraoperative and postoperative conditions,pain,complications and recurrence rates of the two groups were compared.Results There was no statistically significant difference in intraoperative operation time between the two groups of patients(P>0.05);The surgical blood loss in the study group was less than that in the control group,the difference was statistically significant(P<0.05).The postoperative bedtime,gastrointestinal recovery time,and hospitalization time were shorter than those in the control group,the difference was statistically significant(P<0.05).The visual analogue scale(VAS)of the study group was lower than that of the control group at 12 and 24 hours after surgery,the difference was statistically significant(P<0.05).The postoperative complication rate in the study group was 4.55%lower than 20.45%in the control group,the difference was statistically significant(χ^(2)=5.091,P<0.05).At 6 months of follow-up,the recurrence rate of IH in the study group was 0.00%compared to 4.55%in the control group,with no statistically significant difference(χ^(2)=0.512,P>0.05).Conclusion The application of TAPP treatment for IH patients can effectively reduce intraoperative blood loss,shorten the speed of postoperative recovery,and reduce the risk of complications.