| 王辉,孙杰,陈先志,李瑞,张家泉,王琦.腹腔镜下经腹腹膜前疝修补术与疝环充填式无张力疝修补术治疗腹股沟疝的疗效比较[J].中国临床保健杂志,2018,21(2):271-274. |
| 腹腔镜下经腹腹膜前疝修补术与疝环充填式无张力疝修补术治疗腹股沟疝的疗效比较 |
| Effect comparison of laparoscopic and open tension-free hernia repair |
| 投稿时间：2017-12-13 |
| DOI：10.3969/J.issn.1672-6790.2018.02.035 |
| 中文关键词: 疝修补术 腹腔镜检查 疗效比较研究 |
| 英文关键词: Herniorrhaphy Laparoscopy Comparative effectiveness research |
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| 中文摘要: |
| 目的 探讨腹腔镜下经腹腹膜前疝修补术(TAPP)与疝环充填式无张力疝修补术(Mesh-Plug)在腹股沟疝治疗中的应用及临床疗效比较。方法 选取采用TAPP和Mesh-Plug治疗的77例成年腹股沟疝患者的临床病历资料。根据手术方式不同分为TAPP组(37例)和Mesh-Plug组(40例),其中TAPP组采用腹腔镜下经腹腹膜前疝修补术手术治疗,Mesh-Plug组采用开放式疝环充填式无张力疝修补术手术治疗,观察对比两组患者临床治疗效果及在手术时间、住院时间、住院费用、术后并发症(血肿、疼痛等)、近中期复发率等方面的差异。结果 两组患者均获得临床治愈；Mesh-Plug组平均手术时间为(50.25±11.36)min,TAPP组平均手术时间为(48.68±10.23)min；Mesh-Plug组平均住院时间为(10.69±2.36)d,TAPP组平均住院时间为(7.61±2.11)d；Mesh-Plug组出现围术期并发症7例,TAPP组为1例；两组间在手术时间方面差异无统计学意义(P>0.05)；在平均住院日、围手术期并发症等组间比较均差异有统计学意义(P<0.05)；住院费用:TAPP组为(1.25±0.24)万元,Mesh-Plug组为(0.84±0.22)万元,TAPP组费用高于开放组,差异有统计学意义(P<0.05)。术后随访3～24个月,TAPP组复发0例,Mesh-Plug组复发1例,差异无统计学意义(P>0.05)。结论 TAPP和Mesh-Plug在治疗成年腹股沟疝中均具有良好治疗效果,但TAPP较Mesh-Plug具有住院时间短、恢复快、围术期并发症低、慢性疼痛不适感轻等方面的优势,因而在临床应用中更具优势。 |
| 英文摘要: |
| Objective To explore the application and clinical effect of laparoscopic abdominal preperitoneal hernia repair (TAPP) and hernia ring filling tension-free hernia repair (Mesh-Plug) in the treatment of inguinal hernia.Methods Seventy-seven cases of adult inguinal hernia with laparoscopic hernia repair and tension-free hernia repair were selected.They were divided into TAPP group (37 cases) and Mesh-Plug group (40 cases) according to the different ways of operation,laparoscopic transabdominal preperitoneal hernia repair surgery was used in TAPP group and open tension-free hernia repair treatment was used in the Mesh-Plug group.The clinical curative effect,operation time,hospitalization time,hospitalization expenses,postoperative complications (hematoma,pain,etc.),recurrence rate of the short term of two groups were observed and compared.Results Patients of two groups all obtained clinically cure.The average operation time of Mesh-Plug group,and TAPP group were (50.25±11.36)min,(48.68±10.23)min respectively.The average hospitalization time was (10.69±2.36)d,(7.61±2.11)d respectively.Mesh-Plug group perioperative complications appeared in 7 cases,1 cases in group TAPP.There were no significant differences between the two groups in operative time(P>0.05).There were significant differences between the two groups in the average hospitalization days,perioperative complications(P<0.05).The hospitalization expenses of TAPP group and Mesh-Plug group were (12.5±2.4) thousands yuan,(8.4±2.2) thousands yuan respectively,the cost of TAPP group was higher than the open group,the difference was statistically significant(P<0.05).There was 0 cases recurred in group TAPP and 1 cases recurred in Mesh-Plug group after 3-24 months follow-up,there was no significant difference(P>0.05).ConclusionTAPP and Mesh-Plug has a good therapeutic effect for adult abdominal preperitoneal inguinal hernia,but TAPP had shorter hospitalization time,rapid recovery,lower perioperative complications,chronic pain and discomfort,so it has more advantages in clinical application. |
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