腔镜经腹腹膜前疝修补术在中老年腹股沟疝治疗中的应用观察

Observation on the application of transabdominal preperitoneal prosthesis in the treatment of inguinal hernia in middle-aged and elderly people

目的探讨腔镜经腹腹膜前疝修补(TAPP)在中老年腹股沟疝治疗中的临床应用价值。方法回顾性选取2020年1月至2023年6月徐州医科大学附属第三医院收治的中老年单侧腹股沟疝患者52例为研究对象,按照手术方式不同分为对照组和观察组,每组各26例。对照组行开放式无张力疝修补术(OTFH),观察组行TAPP,比较两组手术时间、术中出血量、术后24 h炎症因子水平,并统计并发症及复发率。结果观察组术中出血量少于对照组,手术时间短于对照组,术后24 h超敏C反应蛋白、血清淀粉样蛋白A水平低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。随访3个月后,两组总复发率比较,差异无统计学意义(P>0.05)。结论与OTFH比较,TAPP治疗中老年腹股沟疝,手术时间短,能减少术中出血量,减轻机体炎症应激反应,且降低并发症发生率。

Objective To explore the clinical value of transabdominal preperitoneal prosthesis(TAPP)in the treatment of inguinal hernia in middle-aged and elderly people.Methods A total of 52 middle-aged and elderly patients with unilateral inguinal hernia admitted to the Third Affiliated Hospital of Xuzhou Medical University from January 2020 to June 2023 were analyzed retrospectively.They were divided into the control group and observation group according different surgical methods,with 26 cases in each group.The control group received open tension free hernioplasty(OTFH),while the observation group received TAPP.The operation time,intraoperative blood loss,inflammatory factor level in 24 hours after operation were compared and postoperative complications and recurrence rate were counted.Results The blood loss in the observation group was less than that in the control group,the operation time was shorter than that in the control group,and the levels of hypersensitive C-reactive protein and serum amyloid A at 24 hours after operation were lower than those in the control group,with statistically significant differences(P<0.05).The total incidence of complications in observation group was lower than that in control group,with a statistically significant difference(P<0.05).After 3-month follow-up,there was no significant difference in total recurrence rate between the two groups(P>0.05).Conclusion Compared with OTFH,TAPP in the treatment of inguinal hernia in middle-aged and elderly people can shorten the operation time,reduce the intraoperative blood loss,alleviate the inflammatory and stress reaction of the body,and reduce the complications.