摘要
目的探讨腹腔镜完全腹膜外疝修补术(TEP)与腹腔镜经腹腹膜前疝修补术(TAPP)的优缺点。方法选择2013年6月至2016年12月攀钢总医院收治的325例腹股沟疝患者为研究对象。其中,165例患者进行TEP,设为A组;160例患者进行TAPP,设为B组。观察两组患者的术中出血量、手术时间、术后肠蠕动恢复时间、术后住院时间、住院费用及并发症发生情况。结果两组的手术时间、术中出血量、术后住院时间及住院费用比较,差异无统计学意义(P>0.05);术后肠蠕动恢复时间比较,差异有统计学意义(P<0.05)。两组术后均未复发。A组3例患者中转为TAPP,B组术后1例肠梗阻,两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论 TEP操作较为困难,风险较高,但不需要切开腹膜和缝合,对患者有一定的选择,应由经验丰富的腹腔镜外科医师操作。而TAPP不易失去手术空间,需要切开腹膜及缝合腹膜,对缝合技巧要求较高,对下腹部有手术史和复发疝及双侧疝的患者均适用,在有条件的医院均可以推广。
Objective To investigate the advantages and disadvantages of laparoscopic totally extraperitoneal hernia repair（TEP） and laparoscopic hernia repair before abdominal peritoneum（TAPP）.Methods A retrospective study was performed on 325 patients with inguinal hernia who were admitted from June 2013 to December 2016.Patients were divided into Group A（TEP group,n=165） and Group B（TAPP group,n=160）.The intraoperative blood loss,operative time,postoperative intestinal peristalsis recovery time,hospital stay,postoperative hospitalization costs and complications were observed.Results The operative time,intraoperative blood loss,hospital stay and postoperative hospitalization costs between the two groups had no statistically significant difference（P〉0.05）;the postoperative intestinal peristalsis recovery time between the two groups had statistically significant difference（P〈0.05）.No hemorrhage,recurrence and other complications were performed in both groups.In Group A,3 patients were converted to TAPP,and 1 case of intestinal obstruction was in Group B,and the incidence of complications in both groups had no statistically significant difference（P〉0.05）.Conclusion Conclusion TEP operation is difficult,the risk is higher,while it doesn′t need to cut the peritoneum and suture,which has certain choice for the patient,operation should be carried out by rich experience of laparoscopic surgeons.TAPP is not easy to lose the operation space,needs to cut the peritoneum suture and peritoneum,needs certain suture skill,with lower abdominal surgery history,recurrent hernia and bilateral hernia patients are applicable,which can be applied in conditional hospital.
出处
《创伤与急危重病医学》
2017年第3期172-176,共5页
Trauma and Critical Care Medicine
关键词
腹股沟疝修补术
腹腔镜
完全腹膜外疝修补术
经腹腹膜前疝修补术
Inguinal hernia repair
Laparoscope
Totally extraperitoneal prosthesis
Transabdominal preperitioneal laparoscopie hemiorrhaphy
