摘要
目的探讨腹腔镜下不同术式[腹腔镜全腹膜外疝修补术(TEP)和腹腔镜经腹腹膜前疝修补术(TAPP)]和开放手术疝修补术对腹股沟疝的治疗效果。方法选取180例腹股沟疝患者,按照手术方式不同分为A组、B组、C组,各60例。A组实施开放手术疝修补术,B组实施腹腔镜全腹膜外疝修补术,C组实施腹腔镜经腹腹膜前疝修补术。对比三组手术相关指标、复发情况、术后疼痛评分、术区麻木感评分及并发症发生情况。结果B组和C组的手术时间、疼痛持续时间、下地活动时间、住院时间分别为(48.26±9.37)min、(32.38±7.49)h、(72.51±8.93)h、(7.17±0.97)d和(47.39±8.96)min、(33.26±7.13)h、(70.32±8.59)h、(7.29±0.87)d,均比A组的(68.08±10.74)min、(53.36±8.91)h、(97.65±10.28)h、(9.45±1.84)d更短(P<0.05);B组和C组的手术时间、疼痛持续时间、下地活动时间、住院时间对比没有明显差异(P>0.05)。B组和C组的复发率、术后疼痛评分以及术区麻木感占比分别为3.3%、(1.23±0.67)分、6.7%和3.3%、(1.25±0.53)分、5.0%,均比A组的13.3%、(3.63±0.43)分、16.7%更低(P<0.05);B组和C组复发率、术后疼痛评分以及术区麻木感占比对比没有明显差异(P>0.05)。B组和C组并发症发生率分别为11.7%、10.0%,均比A组的36.7%更低(P<0.05);B组和C组并发症发生率对比没有明显差异(P>0.05)。结论相比开放手术疝修补术,腹腔镜手术(腹腔镜全腹膜外疝修补术和腹腔镜经腹腹膜前疝修补术)治疗腹股沟疝术后疼痛程度和麻木感较轻,并发症少,康复时间短,临床可以根据患者的具体病情选择合适的腹腔镜手术方式。
Objective To explore the therapeutic effect of different laparoscopic hernia repair[laparoscopic total extraperitoneal hernia repair(TEP)and laparoscopic transabdominal preperitoneal hernia repair(TAPP)]and open surgical hernia repair on inguinal hernia.Methods A total of 180 patients with inguinal hernia were selected and divided into group A,group B and group C according to different surgical methods,each with 60 cases.Group A underwent open surgery for hernia repair,group B underwent laparoscopic total extraperitoneal hernia repair,and group C underwent laparoscopic transabdominal preperitoneal hernia repair.The surgery-related indexes,recurrence,postoperative pain score,numbness score in the surgical area and complications were compared among the three groups.Results The operation time,pain duration,off-bed ambulation time and hospitalization time of group B and group C were(48.26±9.37)min,(32.38±7.49)h,(72.51±8.93)h,(7.17±0.97)d and(47.39±8.96)min,(33.26±7.13)h,(70.32±8.59)h,(7.29±0.87)d,which were shorter than(68.08±10.74)min,(53.36±8.91)h,(97.65±10.28)h,(9.45±1.84)d in group A(P<0.05).There were no significant differences in operation time,pain duration,off-bed ambulation time and hospitalization time between group B and group C(P>0.05).The recurrence rate,postoperative pain score and percentage of numbness in the operative area were 3.3%,(1.23±0.67)points,6.7%,3.3%,(1.25±0.53)points and 5.0%in group B and group C,which were lower than 13.3%,(3.63±0.43)points and 16.7%in group A(P<0.05).There were no significant differences in the recurrence rate,postoperative pain score and the percentage of numbness in the operative area between group B and group C(P>0.05).The incidence of complications in group B and group C were 11.7%and 10.0%,which were lower than 36.7%in group A(P<0.05).There was no significant difference in the incidence of complications between group B and group C(P>0.05).Conclusion Compared with open surgery for hernia repair,laparoscopic surgery(laparoscopic total extraperitoneal hernia repair and laparoscopic transabdominal preperitoneal hernia repair)shows light pain and postoperative numbness,less complications and shorter rehabilitation time.Clinically,the appropriate laparoscopic surgery can be selected according to the specific conditions of patients.
作者
聂立煌
NIE Li-huang(Department of General Surgery,Nanchang Xinjian District Hospital of Traditional Chinese Medicine,Nanchang 330100,China)
出处
《中国实用医药》
2025年第7期49-52,共4页
China Practical Medicine
关键词
腹股沟疝
腹腔镜全腹膜外疝修补术
腹腔镜经腹腹膜前疝修补术
开放手术疝修补术
Inguinal hernia
Laparoscopic total extraperitoneal hernia repair
Laparoscopic transabdominal preperitoneal hernia repair
Open surgery for hernia repair
