摘要
目的探讨免精索游离技术在青年男性腹腔镜经腹腹膜前疝修补术(TAPP)中的应用效果。方法选择2018年1月至2019年9月,冀中能源邢台矿业集团有限责任公司总医院行TAPP手术的青年男性患者92例为研究对象。根据患者手术术式分为2组,45例患者接受免精索游离技术的TAPP手术纳入观察组,47例患者接受常规TAPP手术纳入对照组。观察患者手术情况、精液生化指标、腹股沟疝复发情况、长期慢性疼痛、术后并发症。结果观察组手术时间短于对照组,差异有统计学意义(P<0.05)。观察组下床活动时间、术后住院时间、住院费用与对照组比较,差异无统计学意义(P>0.05)。术前,观察组患者精浆果糖、精浆顶体酶水平与对照组比较,差异无统计学意义(P>0.05)。术后3个月,观察组精浆果糖、精浆顶体酶水平与术前比较,差异无统计学意义(P>0.05);对照组精浆果糖、精浆顶体酶水平均低于术前,差异有统计学意义(P<0.05);观察组精浆果糖、精浆顶体酶水平高于对照组,差异有统计学意义(P<0.05)。观察组长期慢性疼痛3例(6.67%),对照组长期慢性疼痛5例(10.64%),2组长期慢性疼痛发生率比较,差异无统计学意义(P>0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论免精索分离在腹腔镜腹股沟疝修补术中具有诸多优势,降低了手术操作难度,缩短手术时间,保护输精管,减少阴囊血肿等并发症,对男性生殖功能影响较小。
Objective To explore the application effect of spermatic cord separation-free in laparoscopic inguinal hernia repair for young men.Methods A total of 92 young men who underwent inguinal hernia repair in the General Hospital of Jinzhong Energy Xingtai Mining Group Co.,Ltd between January 2018 and September 2019 were selected as the study subjects.According to the surgical procedures,they were divided into 2 groups.Forty-five patients undergoing transabdominal preperitoneal herniorrhaphy(TAPP)without spermatic cord separation were included in the observation group,and 47 patients undergoing routine TAPP were included in the control group.The situation of surgery,semen biochemical indexes,recurrence of inguinal hernia,long-term chronic pain and postoperative complications were observed.Results The operation time of the observation group was shorter than that of the control group(P<0.05).There was no significant difference in the amount of leaving bed time,postoperative hospital stays or hospitalization cost between the two groups(P>0.05).At 3 months after surgery,there was no significant difference in the level of seminal plasma fructose or seminal plasma acrosomal enzyme in the observation group,compared with those before surgery(P>0.05).The levels of seminal plasma fructose and seminal plasma acrosomal enzyme in the control group were lower than those before surgery(P<0.05).The levels of above two indexes in the observation group were higher than those in the control group(P<0.05).They were followed up for 3 months after surgery.There was no recurrence in either group.There was no difference in the incidence of long-term chronic pain between the observation group and the control group(6.67%vs 10.64%,P>0.05).The incidence of complications in observation group was lower than that in control group(P<0.05).Conclusion Spermatic cord separation-free has many advantages in laparoscopic inguinal hernia repair.It reduces the difficulty of surgical operation,shortens the operation time,protects the vas deferens,and reduces complications such as scrotal hematoma,with little influence on male reproductive function.
作者
张叶广
郭娟
秦校芳
张志超
牛学瑞
张云昌
Zhang Yeguang;Guo Juan;Qin Xiaofang;Zhang Zhichao;Niu Xuerui;Zhang Yunchang(The Fourth Surgery Department,General Hospital of Jizhong Energy Xingtai Mining Group Co.,Ltd.Xingtai,Xingtai 054000,China)
出处
《中华疝和腹壁外科杂志（电子版）》
2020年第3期293-297,共5页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
基金
邢台市科技计划项目(20192C166)。
关键词
疝
腹股沟
疝修补术
腹腔镜
精索
输精管
并发症
Hernia,inguinal
Herniorrhaphy
Laparoscopes
Spermatic cord
Vas deferens
Complication
作者简介
通信作者:张叶广,Email:whdx889@163.com。
