改良套扎法在腹腔镜完全腹膜外疝修补术中关闭腹膜破裂的临床应用

Clinical application of modified ligation in closing peritoneal tear in laparoscopic totally extraperitoneal hernia repair

目的探讨在腹腔镜完全腹膜外疝修补术(TEP)中应用改良套扎法关闭腹膜破裂的临床疗效。方法选择2019年1月至2022年1月青岛市胶州中心医院收治的316例TEP患者的临床资料,将纳入研究的腹膜破裂者121例依据随机数字表法随机分成改良套扎组(56例)与缝合组(65例)。术后分别观察2组腹膜破裂关闭时间、手术时间、视觉模拟评分(VAS)、住院费用、住院时间及术后总并发症发生率。结果316例TEP术中发生腹膜破裂者124例(39.24%),3例中转为经腹腹膜前疝修补术。2组患者性别、年龄、体重指数、疝分型、破口大小等差异均无统计学意义(P>0.05);2组患者的术后总并发症发生率、住院费用、VAS及住院时间差异无统计学意义(P>0.05);改良套扎组腹膜破裂关闭时间、手术时间较缝合组缩短,差异均有统计学意义(P<0.05)。结论TEP术中采用改良套扎法能有效关闭腹膜破裂口,是一种简单、实用、经济、有效的方法。

Objective To explore the clinical effect of modified ligation in closing peritoneal tears in laparoscopic totally extraperitoneal(TEP)hernia repair.Methods Clinical data of 316 patients who underwent laparoscopic TEP hernia repair in the Jiaozhou Central Hospital of Qingdao City from January 2019 to January 2022 were enrolled,among which 121 patients with peritoneal tears were randomly divided into the modified ligation group(56 cases)and the suture group(65 cases)according to the random number table.The closure time of peritoneal tear,operation time,visual analogue scale(VAS),hospital cost,length of hospital stay and total postoperative complications were compared between the two groups.Results Among the 316 cases of TEP surgery in the two groups,124 cases(39.24%)had peritoneal tears,and 3 cases were converted to transabdominal preperitoneal hernia repair(TAPP).There was no significant difference in gender,age,body mass index(BMI),classification of inguinal hernia,or size of peritoneal tear between the modified ligation group and the suture group(P>0.05).The modified ligation group compared with the suture group,total postoperative complications,hospitalization cost,VAS score,length of hospital stay had no significantly different(P>0.05).Compared with the suture group,the modified ligation group had a shorter closure time for peritoneal tears,and a shorter operative time,with significant statistical significance(P<0.05).Conclusion The modified ligation in the laparoscopic TEP hernia repair can effectively close the peritoneal tear,which is a simple,safe,economical,and effective method.