摘要
目的探讨腹腔镜完全腹膜外疝修补术(TEP)在基层医院治疗腹股沟疝的优势,并绘制TEP手术的学习曲线。方法选取2018年1月至2020年6月期间,在广州市增城区人民医院(现广州医科大学附属第四医院)普通外科接受治疗的85例腹股沟疝患者,根据手术方式的不同分为2组,其中40例接受TEP术治疗,45例接受开放式疝修补术治疗,观察2组的临床治疗效果及安全性。40例接受TEP术的患者按照先后顺序分为A、B、C、D组,每组10例,比较其手术操作情况。结果TEP术治疗腹股沟疝优于开放式疝修补术,主要表现为术中出血量、住院时间、恢复正常活动时间和并发症发生率低(P<0.05),但住院费用高和手术时间长(P<0.05)。对A、B、C、D组分析发现,医师操作20例TEP术后,技术逐渐成熟,术中出血、层次错误、腹膜破裂等现象明显减少。结论基层医院临床治疗腹股沟疝可选取TEP术,其并发症发生率低,术后恢复较快;初学者在完成20例TEP术后,能明显缩短手术时间,并逐渐掌握这一技术。
Objective To explore the advantages of laparoscopic totally extra-peritoneal hernia repair(TEP)in the treatment of inguinal hernia in primary hospital,and to draw the learning curve of TEP operation.Methods From January 2018 to June 2020,85 inguinal hernia patients treated in Department of General Surgery,Zengcheng District People's Hospital of Guangzhou were selected.They were divided into two groups according to surgical methods.40 patients were treated with TEP and 45 patients were treated with open hernia repair.The clinical effect and safety of two groups were observed.40 patients who underwent TEP surgery were divided into group A,B,C and D according to the sequence,with 10 cases in each group.The operation conditions were compared.Results TEP treatment of inguinal hernia is superior to open herniorrhaphy,which is characterized by low intraoperative blood loss,hospitalization time,recovery time and complications(P<0.05),but with high hospitalization cost and long operation time(P<0.05).The analysis of group A,B,C and D showed that after 20 cases of TEP operation,surgeon's technique gradually matured,and the intraoperative bleeding,hierarchical error and peritoneal rupture significantly reduced.Conclusion TEP operation can be selected for the clinical treatment of inguinal hernia in primary hospitals,with low complication rate and fast recovery.After completing 20 cases of TEP,beginners can significantly shorten the operation time and gradually master this technique.
作者
王闯
周晓华
李文宏
谭硕果
梁永艺
曾宪成
Chuang Wang;Xiaohua Zhou;Wenhong Li;Shuoguo Tan;Yongyi Liang;Xiancheng Zeng(Department of General Surgery,the Fourth Affiliated Hospital of Guangzhou Medical University,Guangzhou 511300,China;Department of Ultrasound,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China;Department of General Surgery,the Second People's Hospital of Guang dong Province,Guangzhou 510317,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2022年第5期566-569,共4页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
疝
腹股沟
腹腔镜
疝修补术
疗效
并发症
Hernia
inguinal
Laparoscopes
Herniorrhaphy
Effect
Complication
作者简介
通信作者:曾宪成,Email:13710707889@163.com
