腹腔镜经腹腹膜前疝修补术治疗腹股沟疝的临床效果(1)
[摘要]目的 研究腹腔镜经腹腹膜前疝修补术(TAPP)治疗腹股沟疝的效果。方法 回顾性分析2016年1月～2019年1月我院收治的147例腹股沟疝患者的临床资料，按照不同的治疗方法将其分为腔镜组(69例)和开放组(78例)，腔镜组采用TAPP术式，开放组采用疝环填充式无张力疝修补术。比较两组患者的手术时间、术中出血量、术后住院时间、术后疼痛、术后并发症总发生率。结果 两组患者的手术时间、术中出血量比较，差异无统计学意义(P>0.05)。腔镜组患者的术后住院时间短于开放组，差异有统计学意义(P<0.05);腔镜组患者的术后疼痛率及术后并发症总发生率低于开放组，差异有统计学意义(P<0.05)。结论 腹腔镜TAPP术恢复快、并发症少，可作为首选的治疗方式。
[关键词]腹股沟疝;腹腔镜;无张力疝修补术;经腹腹膜前疝修补术
[中图分类号] R657.8 [文献标识码] A [文章编号] 1674-4721(2020)5(c)-0093-04
Clinical effect of laparoscopic transabdominal preperitoneal hernia repair treating inguinal hernia
RUI Jian-rui1 XU Xin2 TU Yong-jiu1
1. Department of General Surgery， 73rd Group Military Hospital of the PLA Army， Fujian Province， Xiamen 361001， China; 2. Department of Gastroenterology， 73rd Group Military Hospital of the PLA Army， Fujian Province， Xiamen 361001， China
[Abstract] Objective To study the effect of laparoscopic transabdominal preperitoneal hernia repair (TAPP) treating inguinal hernia. Methods The clinical data of 147 patients with inguinal hernia admitted to our hospital from January 2016 to January 2019 were analyzed retrospectively. According to different treatment methods， the patients were divided into the endoscopic group (69 cases) and the open group (78 cases). The endoscopic group was treated with TAPP operation， while the open group was treated with tension-free herniorrhaphy with hernia ring filling. The operative time， intraoperative blood loss， postoperative hospital stay， postoperative pain and total incidence of postoperative complications were compared between the two groups. Results There was no significant difference in operative time and intraoperative blood loss between the two groups (P>0.05). The length of postoperative hospital stay in the endoscopic group was shorter than that in the open group， with statistically significant difference (P<0.05). The total incidence of postoperative pain and postoperative complications in the endoscopic group was lower than that in the open group， and the difference was statistically significant (P<0.05). Conclusion Laparoscopic TAPP can be used as the first choice for treatment because of its rapid recovery and fewer complications.
[Key words] Inguinal hernia; Laparoscopy; Tension-free herniorrhaphy; Transabdominal preperitoneal hernia repair
腹股溝疝是普外科常见病之一，腹股沟疝的发病率，男性为27%～43%，女性为3%～6%[1]。大部分腹股沟疝患者伴有临床症状，典型的临床表现为腹股沟区可复性肿块，可伴有局部坠胀感、恶心、呕吐等临床表现。如发生嵌顿疝或绞窄疝，会出现剧烈腹痛;如嵌顿的为肠管，会出现肠坏死，严重者可危及生命[2-3]，手术是其唯一能根治的方式[1]。对于没有临床症状的腹股沟疝患者，在其后期的观察和随访中，5年内需要手术干预的约占70%[4]。临床中治疗腹股沟疝的手术方式主要包括：传统疝修补术、开放式无张力疝修补术(Lichtenstein术)和腹腔镜腹股沟疝修补术(laparoscopic inguinal hernia repair，LIHR)[5]。传统疝修补术，由于复发率高，现在很少运用。无张力疝修补术，采用补片弥补了传统腹股沟疝修补术的缺点，当前运用较普遍。近年来，随着微创外科理念的普及和手术器械及技术的提高，LIHR术逐渐增多[6]。经腹腹膜前疝修补术(transabdominal preperitoneal hernia repair，TAPP)是LIHR常用的一种术式。本研究回顾性分析我院收治的147例腹股沟疝患者的临床资料，旨在分析和比较腹腔镜TAPP术及疝环填充式无张力疝修补术这两种手术方式治疗腹股沟疝患者的临床效果，现报道如下。, http://www.100md.com(芮建锐 许新 涂永久)
[关键词]腹股沟疝;腹腔镜;无张力疝修补术;经腹腹膜前疝修补术
[中图分类号] R657.8 [文献标识码] A [文章编号] 1674-4721(2020)5(c)-0093-04
Clinical effect of laparoscopic transabdominal preperitoneal hernia repair treating inguinal hernia
RUI Jian-rui1 XU Xin2 TU Yong-jiu1
1. Department of General Surgery， 73rd Group Military Hospital of the PLA Army， Fujian Province， Xiamen 361001， China; 2. Department of Gastroenterology， 73rd Group Military Hospital of the PLA Army， Fujian Province， Xiamen 361001， China
[Abstract] Objective To study the effect of laparoscopic transabdominal preperitoneal hernia repair (TAPP) treating inguinal hernia. Methods The clinical data of 147 patients with inguinal hernia admitted to our hospital from January 2016 to January 2019 were analyzed retrospectively. According to different treatment methods， the patients were divided into the endoscopic group (69 cases) and the open group (78 cases). The endoscopic group was treated with TAPP operation， while the open group was treated with tension-free herniorrhaphy with hernia ring filling. The operative time， intraoperative blood loss， postoperative hospital stay， postoperative pain and total incidence of postoperative complications were compared between the two groups. Results There was no significant difference in operative time and intraoperative blood loss between the two groups (P>0.05). The length of postoperative hospital stay in the endoscopic group was shorter than that in the open group， with statistically significant difference (P<0.05). The total incidence of postoperative pain and postoperative complications in the endoscopic group was lower than that in the open group， and the difference was statistically significant (P<0.05). Conclusion Laparoscopic TAPP can be used as the first choice for treatment because of its rapid recovery and fewer complications.
[Key words] Inguinal hernia; Laparoscopy; Tension-free herniorrhaphy; Transabdominal preperitoneal hernia repair
腹股溝疝是普外科常见病之一，腹股沟疝的发病率，男性为27%～43%，女性为3%～6%[1]。大部分腹股沟疝患者伴有临床症状，典型的临床表现为腹股沟区可复性肿块，可伴有局部坠胀感、恶心、呕吐等临床表现。如发生嵌顿疝或绞窄疝，会出现剧烈腹痛;如嵌顿的为肠管，会出现肠坏死，严重者可危及生命[2-3]，手术是其唯一能根治的方式[1]。对于没有临床症状的腹股沟疝患者，在其后期的观察和随访中，5年内需要手术干预的约占70%[4]。临床中治疗腹股沟疝的手术方式主要包括：传统疝修补术、开放式无张力疝修补术(Lichtenstein术)和腹腔镜腹股沟疝修补术(laparoscopic inguinal hernia repair，LIHR)[5]。传统疝修补术，由于复发率高，现在很少运用。无张力疝修补术，采用补片弥补了传统腹股沟疝修补术的缺点，当前运用较普遍。近年来，随着微创外科理念的普及和手术器械及技术的提高，LIHR术逐渐增多[6]。经腹腹膜前疝修补术(transabdominal preperitoneal hernia repair，TAPP)是LIHR常用的一种术式。本研究回顾性分析我院收治的147例腹股沟疝患者的临床资料，旨在分析和比较腹腔镜TAPP术及疝环填充式无张力疝修补术这两种手术方式治疗腹股沟疝患者的临床效果，现报道如下。, http://www.100md.com(芮建锐 许新 涂永久)