不同方式的腹股沟疝腹膜前无张力疝修补术的临床对比研究
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摘要
目的不同方式的腹膜前无张力疝修补术治疗腹股沟疝的临床对比研究。方法方便选取该院2017年1月—2018年1月收治的114例腹股沟疝患者,随机分为观察组(n=57)和对照组(n=57),观察组行腹腔镜完全腹膜外疝修补术(TEP)治疗,对照组行开腹腹膜前网片植入术治疗,对比两组治疗效果,包括治疗有效率、住院时间、并发症发生率3个方面。结果观察组患者住院时间平均(1.3±0.2)d,对照组为(2.2±0.5)d,组间差异有统计学意义(t=11.547,P<0.05),观察组并发症发生率3.50%,对照组为21.04%,组间差异有统计学意义(χ~2=22.825,P<0.05)。两组治疗有效率均较为100.00%,差异无统计学意义(χ~2=0.003,P>0.05)。结论与开腹腹膜前网片植入术相比,行腹腔镜完全腹膜外疝修补术治疗腹股沟疝结果较理想,能够保证手术效果,也能控制并发症,后续临床工作中可予以推广。
Objective To compare the clinical effects of different kinds of preperitoneal tension-free hernioplasty in the treatment of inguinal hernia. Methods A total of 114 patients with inguinal hernia admitted to our hospital from January2017 to January 2018 were convenient selected and divided into two groups: observation group(n=57) and control group(n=57). The observation group was treated with laparoscopic total extraperitoneal hernia repair(TE), while the control group was treated with open preperitoneal mesh implantation. The therapeutic effects of the two groups were compared, including therapeutic effectiveness, safety, hospitalization time and incidence of complications. Results The average hospitalization time of the patients in the observation group was(1.3±0.2) days, and that of the control group was(2.2±0.5) days. There was a significant difference between the two groups(t=11.547,P<0.05). The incidence of complications in the observation group was3.50%, and that in the control group was 21.04%. There was a significant difference between the two groups(χ~2=22.825,P<0.05). The effective rate of the two groups was 100.00%, the difference was not significant(χ~2=0.003,P>0.05). Conclusion Compared with open preperitoneal mesh implantation, laparoscopic total extraperitoneal herniorrhaphy for inguinal hernia has a better result, which can ensure the operation effect and control complications. It can be popularized in the follow-up clinical work.
Objective To compare the clinical effects of different kinds of preperitoneal tension-free hernioplasty in the treatment of inguinal hernia. Methods A total of 114 patients with inguinal hernia admitted to our hospital from January2017 to January 2018 were convenient selected and divided into two groups: observation group(n=57) and control group(n=57). The observation group was treated with laparoscopic total extraperitoneal hernia repair(TE), while the control group was treated with open preperitoneal mesh implantation. The therapeutic effects of the two groups were compared, including therapeutic effectiveness, safety, hospitalization time and incidence of complications. Results The average hospitalization time of the patients in the observation group was(1.3±0.2) days, and that of the control group was(2.2±0.5) days. There was a significant difference between the two groups(t=11.547,P<0.05). The incidence of complications in the observation group was3.50%, and that in the control group was 21.04%. There was a significant difference between the two groups(χ~2=22.825,P<0.05). The effective rate of the two groups was 100.00%, the difference was not significant(χ~2=0.003,P>0.05). Conclusion Compared with open preperitoneal mesh implantation, laparoscopic total extraperitoneal herniorrhaphy for inguinal hernia has a better result, which can ensure the operation effect and control complications. It can be popularized in the follow-up clinical work.
引文
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[12] Ashraf El-Sharkawy,Hazem Mostafa Badr,Rasha Abd ElAziz Abd El-Gany. Self-fixating Parietex ProGrip mesh in inguinal and paraumbilical hernia repair[J]. The Scientific Journal of Al-Azhar Medical Faculty, Girls,2018,2(1).
[2]李健文,乐飞.腹股沟疝无张力修补术术式演变与合理选择[J].中国实用外科杂志,2017,37(11):1202-1205.
[3]唐健雄,郑民华,陈杰,等.腹腔镜腹股沟疝手术操作指南(2017版)[J].中国实用外科杂志,2017,37(11):1238-1242.
[4]黄永刚,王平.腹股沟疝常用临床分型标准评价[J].中国实用外科杂志,2017,37(11):1292-1295.
[5]成人腹股沟疝诊断和治疗指南(2018年版)[J].中国实用外科杂志,2018,38(7):704-706.
[6]王学虎,赵渝.腹股沟疝修补术后并发症原因分析及处理[J].中国实用外科杂志,2017,37(11):1231-1234.
[7]马颂章.疝和腹壁外科手术图谱.北京.人民军医出版社,2008:88-92,239-245.
[8]马颂章.疝外科学[M].5版.北京:人民卫生出版社,2003:168-185,221-234,259-269,275-300.
[9]唐健雄,黄磊.腹壁疝外科治疗学[M].4版.上海.上海科学技术出版社,2014:23-48,265-278.
[10] BrianP.Jacob,BruceRanshaw.The SAGES Manual of Hernia Repair[M].Springer,2016:63-70,107-113,121-132.
[11] M. Masood Sidiqi,Geoffrey Menezes. Asymptomatic Herniation of Ureter In The Routine Inguinal Hernia:a Dangerous Trap For General Surgeons[J]. International Journal of Surgery Case Reports,2018,49:244-246.
[12] Ashraf El-Sharkawy,Hazem Mostafa Badr,Rasha Abd ElAziz Abd El-Gany. Self-fixating Parietex ProGrip mesh in inguinal and paraumbilical hernia repair[J]. The Scientific Journal of Al-Azhar Medical Faculty, Girls,2018,2(1).