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腹腔镜经腹腹膜前疝修补术治疗嵌顿性腹股沟疝

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  • 南京医科大学附属常州市第二人民医院疝外科,江苏 常州 213003

收稿日期: 2021-11-12

  网络出版日期: 2023-01-30

Transabdominal preperitoneal laparoscopic hernia repair in treatment of incarcerated inguinal hernia

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  • Department of Hernia Surgery, Changzhou No.2 People′s Hospital, the Affiliated Hospital of Nanjing Medical University, Jiangsu Changzhou 213003, China

Received date: 2021-11-12

  Online published: 2023-01-30

摘要

目的: 评价腹腔镜经腹腹膜前疝修补术治疗嵌顿性腹股沟疝的临床效果。方法: 回顾性分析2015年1月至2019年12月,我院收治手术的嵌顿性腹股沟疝44例临床资料。24例腹腔镜经腹腹膜前疝修补术为研究组,20例Lichtenstein术为对照组。比较两组手术时间、术后首次下床时间、术后住院时间、术后第1天疼痛评分、住院总费用等资料。术后随访12个月,比较两组术后血清肿、切口感染、补片感染、复发等术后情况。结果: 与对照组比较,研究组手术时间较长[(80.96±13.25) min比(64.90±18.80) min,P<0.05],住院总费用较高[(16 389.07±2 034.72)元比(12 516.52±2 545.90)元,P<0.05]。研究组术后首次下床时间[(8.42±3.60) h比(11.00±3.52) h,P<0.05]及术后住院时间较短[(3.88±0.90) d比(4.80±1.32) d,P<0.05]。研究组术后第1天疼痛评分较对照组低[(2.25±0.74)分比(2.80±0.70)分,P<0.05]。研究组术后血清肿、切口感染,与对照组比较,差异无统计学意义(P>0.05)。结论: 虽然腹腔镜经腹腹膜前疝修补术治疗嵌顿性腹股沟疝手术时间较长、费用较高,但其具有术后疼痛轻和恢复快的优点。

本文引用格式

杨良根, 朱俊强, 胡星辰 . 腹腔镜经腹腹膜前疝修补术治疗嵌顿性腹股沟疝[J]. 外科理论与实践, 2022 , 27(06) : 551 -554 . DOI: 10.16139/j.1007-9610.2022.06.014

Abstract

Objective: To evaluate the clinical effect of transabdominal preperitoneal laparoscopic hernia repair in the treatment of incarcerated inguinal hernia. Methods: Retrospective analysis was done with the clinical data of 44 patients of incarcerated inguinal hernia enrolled and operated in our hospital from January 2015 to December 2019. Twenty-four cases in study group were treated with transabdominal preperitoneal laparoscopic hernia repair and 20 cases undergoing Lichtenstein surgery in control group. Operative time, the time of first postoperative off-bed activities, postoperative hospital stay, pain score of first postoperative day, total hospital cost were compared between two groups. Follow-up was done for 12 months and postoperative seroma, incision infection, mesh infection, and recurrence were compared between two groups. Results: Operative time and total hospital cost in study group were higher than those in control group,(80.96±13.25) min vs. (64.90±18.80) min (P<0.05), (16 389.07±2 034.72) yuan vs. (12 516.52±2 545.90) yuan (P<0.05). However, the time of first off-bed activity after operation and postoperative hospital stay were shorter in study group than those in control group, (8.42±3.60) h vs. (11.00±3.52) h (P<0.05), (3.88±0.90) d vs. (4.80±1.32) d (P<0.05). Pain score of first day was lower in study group than in control group (2.25±0.74) vs. (2.80±0.70) (P<0.05). There were no significant differences in postoperative seroma, incision infection between study group and control group(P>0.05). Conclusions: Transabdominal preperitoneal laparoscopic hernia repair in the treatment of incarcerated inguinal hernia had longer operative time and higher cost, but with the advantages of less pain and faster recovery after surgery.

参考文献

[1] 张晨波, 李健文. 应用腹腔镜技术治疗腹股沟嵌顿疝争议与挑战[J]. 中国实用外科杂志, 2015, 35(5):502-505.
[2] 陈继安, 靳小建, 陈永军, 等. 成人腹股沟嵌顿疝治疗新进展[J]. 中华疝和腹壁外科杂志, 2018, 12(4):249-251.
[3] Matthew EG, Lava P, Francis D, et al. Laparoscopic total extra peritoneal groin hernia repair and quality of life at 2-year follow-up[J]. J Am Coll Surg, 2016, 223(1):153-161.
[4] Bittner JG 4th. Incarcerated/strangulated hernia: open or laparoscopic?[J]. Adv Surg, 2016, 50(1):67-78.
[5] 中华医学会外科学分会疝与腹壁外科学组, 中国医师协会外科医师分会疝和腹壁外科医师委员会. 成人腹股沟疝诊断和治疗指南(2018年版)[J]. 中华外科杂志, 2018, 56(7):495-498.
[6] Poelman MM, van den Heuvel B, Deelder JD, et al. EAES consensus development conference on endoscopic repair of groin hernias[J]. Surg Endosc, 2013, 27(10):3505-3019.
[7] 张迪, 赖建勤, 黄华平, 等. 腹腔镜与开放手术治疗双侧腹股沟疝疗效及安全性的meta分析[J]. 腹腔镜外科杂志, 2020, 25(12):881-888.
[8] Mancini R, Pattaro G, Spaziani E. Laparoscopic trans-abdominal pre-peritoneal (TAPP) surgery for incarcerated inguinal hernia repair[J]. Hernia, 2019, 23(2):261-266.
[9] 黄建朋, 陈亮, 韩明福. 腹腔镜经腹腹膜前疝修补术治疗嵌顿性腹股沟疝的应用价值[J]. 中华疝和腹壁外科杂志, 2016, 10(6):460-461.
[10] 金曜, 汪翰, 杨帆, 等. 腹腔镜技术在嵌顿性腹股沟疝中的应用[J]. 临床外科杂志, 2021, 29(9):857-859.
[11] 姜峰, 台德军, 蔡绍海. 老年腹股沟疝患者行疝修补术后并发症的多因素Logistic回归分析[J]. 中华疝和腹壁外科杂志, 2020, 14(5):467-471.
[12] 李绍春, 李绍杰, 黄磊, 等. Halsted术式在急诊疝修补中的应用体会[J]. 外科理论与实践, 2021, 26(5):416-419.
[13] 李绍春, 李绍杰, 唐健雄. 利用生物材料行腹股沟后壁加强重建技术[J]. 中国实用外科杂志, 2020, 40(7):851-853.
[14] Scheuermann U, Niebisch S, Lyros O, et al. Transabdo-minal preperitoneal(TAPP) versus lichtenstein operation for primary inguinal hernia repair—a systematic review and meta-analysis of randomized controlled trials[J]. BMC Surg, 2017, 17(1):55.
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