摘要
目的比较分析腹腔镜经腹腹膜前疝修补术(TAPP)与李金斯坦(Lichtenstein)疝修补术治疗成人原发性腹股沟疝的疗效,为基层医师选择合适的手术方式提供临床依据。方法回顾性收集2019年1月至2020年1月,南京市高淳人民医院普通外科收治的80例成人原发性腹股沟疝患者的临床资料。按照手术方式的不同将患者分为两组:试验组行TAPP,对照组行Lichtenstein术,各40例。对比两组患者围手术期相关指标(手术时间、术中出血量、住院时间、住院费用)、术后24 h疼痛评分、术后并发症(血清肿、尿潴留、手术部位感染、慢性疼痛)和复发情况。结果两组患者一般资料具有可比性。术后试验组与对照组分别平均随访(20.6±3.3)个月和(21.4±2.1)个月。试验组术中出血量(7.35±1.31)ml、住院时间(3.13±0.72)d、术后24 h疼痛评分(1.63±0.54)分、腹股沟区慢性疼痛发生率2.5%,均低于对照组[(11.95±1.01)ml、(4.68±0.62)d、(2.65±0.62)分、20.0%](P<0.05)。试验组手术时间(73.65±6.14)min、住院费用(10688.55±2624.58)元、尿潴留发生率20%,均明显高于对照组[(40.78±6.7)min、(6390.50±988.77)元、2.5%](P<0.05)。两组其他指标比较差异无统计学意义。结论TAPP是一种安全、可行的术式,与Lichtenstein术相比术中出血量少、术后24 h疼痛程度轻、住院时间短、术后慢性疼痛的发生率低,但花费较高,手术时间较长。临床上要具体病例具体分析,采取个体化的手术方式。
Objective To compare and analyze the efficacy of laparoscopic transabdominal preperitoneal hernia repair(TAPP)and Lichtenstein hernia repair in the treatment of primary inguinal hernia in adults,and to provide a clinical basis for primary care physicians to choose the appropriate surgical approach.Methods The clinical data of 80 adult primary inguinal hernia patients admitted to the Department of General Surgery of Gaochun People's Hospital in Nanjing from January 2019 to January 2020 were retrospectively collected.The patients were divided into two groups according to the operation mode:the experimental group underwent TAPP,and the control group underwent Lichtenstein hernia repair,with 40 cases in each group.The perioperative related indexes(operation time,intraoperative bleeding,hospitalization time,hospitalization cost),postoperative 24 h pain score,postoperative complications(seroma,urinary retention,infectionat the surgical site,chronic pain),and recurrence were compared between the two groups.Results The general data of the two groups of patients were comparable.The average follow-up time was(20.6±3.3)months in the experimental group and(21.4±2.1)months in the control group..Intraoperative bleeding(7.35±1.31)ml,length of hospitalization(3.13±0.72)d,postoperative 24-h pain score(1.63±0.54),and incidence of chronic pain in the inguinal region(2.5%)in the experimental group were less than those in the control group[(11.95±1.01)ml、(4.68±0.62)d、(2.65±0.62)、20.0%],(P<0.05).The experimental group's operation time(73.65±6.14)min was significantly longer than that of the control group(40.78±6.7)min(P<0.05).The cost of the experimental group during hospitalization(10688.55±2624.58)yuan,the incidence of urinary retention(20%)was significantly higher than that of the control group[(6390.50±988.77)yuan、2.5%](P<0.05);and the difference of other indexes between the two groups was not statistically significant.Conclusion TAPP is a safe and feasible surgical procedure,and compared with Lichtenstein hernia repair,it can reduce intraoperative bleeding,postoperative 24 h pain score,hospitalization time,and the incidence of postoperative chronic pain,but the cost is higher and the operation time is longer.Clinically,a case-by-case analysis is required to adopt an individualized surgical approach.
作者
周晓华
芮鸿庆
徐光齐
王礽
濮阳永强
孔荷香
Zhou Xiaohua;Rui Hongqing;Xu Guangqi;Wang Reng;Puyang Yongqiang;Kong Hexiang(Department of General Surgery,Nanjing Gaochun People's Hospital,Nanjing 211300,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2023年第4期432-436,共5页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
疝修补术
疝
腹股沟
疗效
Herniorrhaphy
Hernia,Inguinal
Effect
作者简介
通信作者:孔荷香,Email:grywcwkkhx@163.com
