腹腔镜下经腹腹膜前腹股沟疝修补术独创七针法连续缝合固定补片的临床疗效分析

Clinical Efficacy Analysis of Original Seven-Needle Suture Fixation for Laparoscopic Transperitoneal Anterior Inguinal Hernia Repair

目的:回顾性分析腹腔镜经腹腹膜前腹股沟疝修补术(TAPP)七针法连续缝合固定补片的效果。方法:选取2016年1月~2018年12月厦门市中医院普外科收治的106例Nyhus-StoppaⅠ、Ⅱ、Ⅲ型成人腹股沟疝患者为研究对象,将其分为对照组与观察组,每组53例。对照组采用TAPP术,观察组采用TAPP+可吸收线七针法连续缝合固定术,比较两组围手术期相关临床指标。结果:两组的性别、年龄构成、腹股沟疝的类型与分型差异无统计学意义,对照组手术时间更短(P<0.05),手术出血量、下床活动时间、排气时间、住院时间、术后疼痛情况、术后并发症发生率、慢性疼痛发生率无明显差异(P>0.05);术后随访5年,复发率观察组低于对照组,差异有统计学意义(P<0.05)。结论:TAPP+补片七针法连续缝合固定术虽然手术时间稍长,但并发症发生率无异,复发率更低,具有较高的临床应用价值。

Objective:To retrospectively analyze the effect of laparoscopic transperitoneal anterior inguinal hernia repair(TAPP).Methods:106 adult patients with Nyhus-Stoppa type I,II,and III inguinal hernia admitted to General Surgery Department of Xiamen Hospital of Traditional Chinese Medicine from January 2016 to December 2018 were selected and divided into control group and test group with 53 patients in each group.The control group used TAPP,and the observation group used continuous suture fixation to compare the perioperative related clinical indicators between the two groups.Results:There was no significant difference in gender,age composition,type of inguinal hernia and classification,the control group had shorter operation time(P<0.05),bleeding,ambulation,exhaust time,hospital stay,postoperative pain,postoperative complication rate,incidence of chronic pain(P>0.05);After a 5-year follow-up,the recurrence rate in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Although the operation time of TAPP+patch continuous suture fixation is slightly longer,the complication rate is different and the recurrence rate is lower,which has high clinical application value and is worth popularizing.