摘要
目的:探讨内环口关闭技术在腹腔镜全腹膜外疝修补术(TEP)治疗Ⅲ型斜疝中的应用效果。方法:将2023年1月1日至2024年6月30日收治的86例Ⅲ型斜疝患者随机分为内环口关闭组与未关闭组,每组43例。关闭组采用3-0倒刺线连续缝合关闭内环口,未关闭组不做特殊处理。主要对比指标为术后第7天、1个月、3个月、6个月血清肿发生率及血清肿积液量,次要指标包括手术时间、出血量、住院费用、住院时间、疼痛评分、术后并发症、复发率等。结果:86例患者均顺利完成TEP,两组患者基本资料差异无统计学意义;关闭组手术时间长于未关闭组,住院费用多于未关闭组(P<0.001)。两组横断疝囊比例、住院时间、出血量、术后疼痛评分差异无统计学意义(P>0.05)。术后第7天、1个月,关闭组血清肿发生率低于未关闭组(P<0.001);术后3个月、6个月,两组血清肿发生率差异无统计学意义(P>0.05)。术后第7天、1个月、3个月,两组血清肿积液量差异有统计学意义(P<0.001、P<0.001、P=0.029)。随访期间,两组均无疝复发、补片感染、慢性疼痛。结论:TEP内环口关闭技术治疗Ⅲ型斜疝是安全的,可有效减少术后血清肿的发生,且不增加其他并发症,值得临床应用。
Objective:To investigate the application effect of the internal ring orifice closure technique in laparoscopic totally extraperitoneal(TEP)repair for typeⅢindirect inguinal hernia.Methods:From Jan.1,2023 to Jun.30,2024,86 patients with typeⅢindirect inguinal hernia were randomly divided into a closure group and a non-closure group,with 43 cases in each group.The closure group was treated with continuous suture of the internal ring orifice using 3-0 barbed suture,while the non-closure group received no special treatment.The primary outcomes were the incidence of seroma and volume of serous fluid at 7 days,1 month,3 months,and 6 months postoperatively.The secondary outcomes included operation time,blood loss,hospitalization cost,hospital stay,pain score,postoperative complications,and recurrence rate.Results:All 86 patients underwent TEP surgery successfully.There were no significant differences in baseline characteristics between the 2 groups.The operation time of the closure group was longer than that of the non-closure group,and the hospitalization cost was also higher(P<0.001).However,there was no statistically significant difference in the p roportion of transected hernia sacs,hospital stay,and postoperative pain scores between the two groups(P>0.05).At 7 days and 1 month after surgery,the incidence of seroma in the closure group was significantly lower than that in the non-closure group(P<0.001).At 3 months and 6 months after surgery,there was no statistically significant difference in the incidence of seroma between the two groups(P>0.05).The volume of serous fluid differed significantly between the two groups at 7 days,1 month,and 3 months after surgery(P<0.001,P<0.001,P=0.029).During the follow-up period,there were no cases of hernia recurrence,mesh infection,or chronic pain in either group.Conclusions:The internal ring orifice closure technique can be safely applied in TEP for typeⅢindirect hernia.This technique can effectively reduce the incidence of postoperative seroma without increasing other complications.It is worthy of clinical application.
作者
莫宇轩
汤凌佳
MO Yuxuan;TANG Lingjia(Department of Gastrointestinal Surgery,Ningbo No.2 Hospital,Ningbo 315010,China;Department of Geriatric Medicine,Ningbo No.2 Hospital)
出处
《腹腔镜外科杂志》
2025年第8期604-608,共5页
Journal of Laparoscopic Surgery
基金
宁波市第二医院华美研究基金(2023HMKY38)。
关键词
疝
腹股沟
疝修补术
全腹膜外
腹腔镜检查
血清肿
内环口关闭
Hernia,inguinal
Herniorrhaphy
Totally extraperitoneal
Laparoscopy
Seroma
Closure of internal ring orifice
