摘要
目的:对比小切口无张力疝修补术联合阴囊引流与腹腔镜经腹腹膜前疝修补术的临床疗效。方法:回顾分析2018年6月至2023年2月手术治疗的腹股沟疝患者的临床资料,其中107例行小切口无张力疝修补术联合阴囊引流(A组),216例行腹腔镜经腹腹膜前疝修补术(B组)。对比两组术中、术后及随访情况。结果:A组术中出血量多于B组,手术时间短于B组,术后排气时间、卧床时间、明显疼痛时间、住院时间长于B组,医疗费用低于B组,差异均有统计学意义(P<0.001);A组拔除引流管时间平均(2.03±0.65)d。两组慢性疼痛、异物感、尿潴留、血清肿或阴囊水肿、复发率差异均无统计学意义(P>0.05);A组切口感染率高于B组,差异有统计学意义(P<0.05)。结论:小切口无张力疝修补术联合阴囊引流与腹腔镜经腹腹膜前疝修补术治疗腹股沟疝均是安全、有效的;小切口无张力疝修补术费用低,适于无法耐受全麻且对医疗费用、切口美观有要求的患者,联合阴囊引流可预防术后血清肿或阴囊血肿的发生,技术简单,适合在基层医院开展。
Objective:To compare the efficacy of small incision tension-free hernia repair combined with scrotal drainage with laparoscopic transabdominal preperitoneal hernia repair(TAPP).Methods:Clinical data of patients with inguinal hernia who under-went surgery from Jun.2018 to Feb.2023 were retrospectively analyzed.107 cases of small incision tension-free hernia repair combined with scrotal drainage were classified as group A,and 216 cases of TAPP were classified as group B.The intraoperative,postoperative and follow-up conditions were compared between the two groups.Results:Intraoperative blood loss in group A was significantly more than that in group B,the operative time was significantly shorter than that in group B,the time of postoperative exhaust,ambulation,obvious pain and hospital stay in group A were significantly longer than those in group B,the medical cost was significantly lower than that in group B,the differences were statistically significant(P<0.001).The average drainage tube removal time in group A was(2.03±0.65)d.The differences between the two groups in chronic pain,foreign body sensation,urinary retention,seroma or scrotal edema,and recurrence rate were not statistically significant(P>0.05);incision infection incidence in group A was significantly higher than that in group B with statistical difference(P<0.05).Conclusions:Small incision tension-free hernia repair combined with scrotal drainage and TAPP are safe and effective in the treatment of inguinal hernia.For those who cannot tolerate general anesthesia,have the requirement of low cost and incision aesthetics,small incision tension-free hernia repair is appropriate,and the combination of scrotal drainage can pre-vent postoperative seroma or scrotal hematoma,which is a simple technique and suitable for primary hospitals.
作者
任航军
张莲美
REN Hangjun;ZHANG Lianmei(Department of General Surgery,the First People's Hospital of Yuhang District,Hangzhou 311100,China;Department of Thyroid and Breast Surgery,Yanbian University Hospital)
出处
《腹腔镜外科杂志》
2024年第6期457-461,共5页
Journal of Laparoscopic Surgery
关键词
疝
腹股沟
经腹腹膜前疝修补术
无张力
小切口
阴囊引流
腹腔镜检查
疗效比较研究
Hernia,inguinal
Transabdominal preperitoneal herniorrhaphy
Tension-free
Small incision
Scrotal drainage
La-paroscopy
Comparative effectiveness research
作者简介
通讯作者:张莲美,E-mail:2224272992@qq.com;任航军(1991-)男,浙江省杭州市余杭区第一人民医院普通外科住院医师,主要从事结直肠肿瘤方面的研究。
