不同补片固定方式在腹股沟疝腹腔镜完全腹膜外疝修补术中的应用价值探讨

Value of different methods of mesh fixation in laparoscopic totally extraperitoneal herniorrhaphy for inguinal hernia

目的探讨不同补片固定方式在腹股沟疝腹腔镜完全腹膜外(TEP)疝修补术中的应用价值。方法选取2020年3月—2023年3月北京市平谷区中医医院收治的100例腹股沟疝患者,按照治疗方式的不同分为免固定组(67例,采用自固定补片进行腹腔镜TEP疝修补术)和医用胶组(33例,采用传统补片进行腹腔镜TEP疝修补术);对两组患者临床资料进行比较分析。结果两组手术时间及术中出血量比较,差异无统计学意义(P>0.05),免固定组肛门首次排气时间、术后进食时间、自主活动时间及住院时间均显著短于医用胶组(P<0.05);经治疗,两组患者视觉模拟评分法(VAS)评分、健康调查量表36(SF-36)评分均得到显著改善(P<0.05),且免固定组治疗后各时间点VAS评分及术后6个月SF-36评分均显著优于医用胶组(P<0.05);免固定组术后并发症发生率显著低于医用胶组(P<0.05)。结论采用自固定补片腹腔镜TEP疝修补术治疗腹股沟疝可促进患者术后康复,同时显著降低术后并发症,值得临床借鉴推广。

Objective To evaluate the value of different mesh fixation methods in laparoscopic totally extraperitoneal(TEP)herniorrhaphy for inguinal hernia.Methods A total of 100 patients with inguinal hernia treated in Beijing Pinggu District Hospital of Traditional Chinese Medicine from March 2020 to March 2023 were selected and divided into two groups according to different treatment methods:non-fixation group(67 cases,laparoscopic TEP herniorrhaphy with self-fixation mesh)and medical adhesive group(33 cases,laparoscopic TEP herniorrhaphy with traditional mesh).The clinical data of the two groups were compared and analyzed.Results There was no significant difference between the two groups in operative time and amount of bleeding(P>0.05).The time of first anal exsufflation,eating after operation,free movement and hospitalization in the non-fixed group were significantly shorter than those in the medical adhesive group(P<0.05).After treatment,the visual analogue scale(VAS)and short form 36-item health survey(SF-36)scores of both groups were significantly improved(P<0.05),and the VAS and SF-36 scores at 6 months after operation in the non-fixed group were significantly better than those in the medical adhesive group(P<0.05).The incidence rate of postoperative complications in the non-fixation group was significantly lower than that in the medical adhesive group(P<0.05).Conclusion The laparoscopic TEP herniorrhaphy for inguinal hernia with self-fixed mesh can promote the postoperative rehabilitation of patients,and can significantly reduce the postoperative complications,which is worthy of clinical promotion.