本文關(guān)鍵詞：腹腔鏡下全腹膜外腹股溝疝修補(bǔ)術(shù)與經(jīng)正中線切口腹膜前腹股溝疝修補(bǔ)術(shù)的比較研究　出處：《中國微創(chuàng)外科雜志》2016年02期 　論文類型：期刊論文

  更多相關(guān)文章： 腹股溝疝 疝修補(bǔ)術(shù) 正中切口 腹膜前 腹腔鏡

【摘要】：目的比較腹腔鏡下全腹膜外腹股溝疝修補(bǔ)術(shù)(total extraperitoneal repair,TEP)與經(jīng)正中線切口腹膜前腹股溝疝修補(bǔ)術(shù)治療成人腹股溝疝的效果。方法 2011年1月~2014年12月,94例成人腹股溝疝采用腹腔鏡下完全腹膜外游離腹膜前間隙,放置補(bǔ)片(TEP組),83例成人腹股溝疝采用下腹正中小切口游離腹膜前間隙,放置補(bǔ)片(開放組),比較2組手術(shù)時間、住院時間、住院費(fèi)用、術(shù)后應(yīng)用止痛藥物情況、血清腫與切口裂開情況等。結(jié)果 TEP組手術(shù)時間(76±14)min,明顯長于開放組(47±8)min(t=16.623,P=0.000);住院費(fèi)用(9568.95±1422.23)元,明顯高于開放組(5327.75±662.76)元(t=24.881,P=0.000);開放組術(shù)后應(yīng)用鎮(zhèn)痛劑(15例vs.6例,χ2=5.760,P=0.016)、切口脂肪液化裂開(4例vs.0例,P=0.046,)例數(shù)均明顯高于TEP組;TEP組住院時間(4.9±0.6)d,與開放組(5.0±0.5)d無統(tǒng)計學(xué)差異(t=-1.195,P=0.234);2組血清腫無統(tǒng)計學(xué)差異(6例vs.1例,χ2=2.937,P=0.087)。177例隨訪3~12個月,平均7.4月,2組均無疝復(fù)發(fā)、補(bǔ)片感染、慢性疼痛、睪丸萎縮等并發(fā)癥發(fā)生。結(jié)論開放手術(shù)在手術(shù)時間和住院費(fèi)用上較TEP有明顯優(yōu)勢,但術(shù)后疼痛、切口并發(fā)癥高于TEP組,更適合雙側(cè)疝及復(fù)發(fā)疝,對單側(cè)初發(fā)疝的治療無明顯優(yōu)勢。
[Abstract]:Objective to compare the effect of laparoscopic totally extraperitoneal total extraperitoneal repair (TEP) and anterior median inguinal herniorrhaphy in the treatment of inguinal hernia in adults. Methods ~2014 in January 2011 December, 94 cases of adult inguinal hernia by laparoscopic totally extraperitoneal free preperitoneal space, place the patch (TEP group), 83 cases of adult inguinal hernia by abdominal incision is small free preperitoneal space, place the patch (open group), compared 2 groups of operation time, hospitalization time and cost application of analgesic drugs, seroma and wound dehiscence after operation. Results the operation time of TEP group (76 + 14) min, significantly longer than the open group (47 + 8) min (t=16.623, P=0.000); hospitalization expenses (9568.95 + 1422.23), significantly higher than that of open group (5327.75 + 662.76) element (t=24.881, P=0.000); the open group of postoperative analgesic (15 cases of vs.6 an example, X 2=5.760, P=0.016), incision fat liquefaction dehiscence (4 cases vs.0 cases, P=0.046 cases) were significantly higher than that in TEP group; in TEP group (4.9 + 0.6) d, and the open group (5 + 0.5) d no significant difference (t=-1.195, P=0.234); the 2 groups showed no seroma the difference (6 vs.1 cases, X 2=2.937, P=0.087). 177 cases were followed up for 3~12 months, with an average of 7.4 months. There were no complications such as hernia recurrence, patch infection, chronic pain and testicular atrophy in the 2 groups. Conclusion open surgery has a significant advantage over TEP in terms of operative time and hospitalization cost, but postoperative pain and incision complications are higher than those of TEP group. It is more suitable for bilateral hernia and recurrent hernia, and has no obvious advantage for the treatment of unilateral primary hernia.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京世紀(jì)壇醫(yī)院普通外科;
【基金】：北京市衛(wèi)生和計劃生育委員會“北京市衛(wèi)生系統(tǒng)高層次衛(wèi)生技術(shù)人員培養(yǎng)計劃”(項(xiàng)目編號:Z201412201712)
【分類號】：R656.21
【正文快照】： 疝的治療應(yīng)盡量簡單,根據(jù)解剖知識、技術(shù)修復(fù)腹壁,根據(jù)疝形成的機(jī)制防止復(fù)發(fā)[1]。腹股溝疝修補(bǔ)術(shù)根據(jù)手術(shù)路徑與疝環(huán)的關(guān)系有前、后入路之分[2]。目前,開放后入路手術(shù)被越來越多的嘗試用于初發(fā)疝的治療。腹腔鏡下全腹膜外腹股溝疝修補(bǔ)術(shù)(total extraperitoneal repair,TEP)是

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 楊曉軍,董劍宏;普理靈立體補(bǔ)片在腹股溝疝修補(bǔ)術(shù)中的應(yīng)用附85例報告[J];實(shí)用醫(yī)技雜志;2003年12期

2 Hansen K.A.;Eyster K.M. ;張e，

本文編號：1339308