發(fā)布時間：2018-02-20 04:49

  本文關(guān)鍵詞： 腹股溝疝 免輸精管分離 生殖功能 腹腔鏡下完全腹膜外腹股溝疝修補　出處：《蘇州大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：背景與目的TAPP與TEP是目前腹腔鏡下腹股溝疝修補的兩種主流術(shù)式。但這兩種術(shù)式都可能對男性生殖功能造成影響。為了解決這一問題,現(xiàn)已設(shè)計施行了腹腔鏡下免輸精管分離腹股溝疝修補術(shù),為了觀察它的臨床價值和作用,我們對它和TEP進行了對比研究。方法抽取2012年3月-2015年2月蘇州大學(xué)附屬第一醫(yī)院普外科進行的68例腹腔鏡下免輸精管分離腹股溝疝修補術(shù)的患者資料。采集手術(shù)時間,術(shù)后住院天數(shù),術(shù)后疼痛,術(shù)后并發(fā)癥,生殖功能情況等數(shù)據(jù),與同期進行的53例TEP手術(shù)病例資料進行對比分析。結(jié)果TEP組的手術(shù)時間(59.26±23.50min vs 85.18±14.60min)、術(shù)后住院天數(shù)(1.30±0.54d vs 2.18±0.52d)、住院費用(11182.43±1038.59元vs 11979.81±1550.24元)較免輸精管分離腹股溝疝修補組少,兩組間有統(tǒng)計學(xué)意義(P0.01)。免輸精管分離組與TEP組間的并發(fā)癥術(shù)后疼痛(1.5%vs 1.9%)、血清腫(2.9%vs 1.9%)、血腫(1.5%vs 1.9%)、尿潴留(1.5%vs 1.9%)、陰囊氣腫、精索離斷、異物感、腸梗阻、射精功能障礙等發(fā)生率并無差異。免輸精管分離組術(shù)前術(shù)后的生殖功能無明顯差異(P0.05)。隨訪2-28個月,兩組均無復(fù)發(fā)病例。結(jié)論腹腔鏡下免輸精管分離腹股溝疝修補術(shù)與TEP在并發(fā)癥、復(fù)發(fā)率及住院費用等無明顯差異。但前者免除了疝囊與輸精管的分離,因此簡化了操作,還保護了輸精管和精索血管,因此具有一定的臨床應(yīng)用及進一步探討的價值。
[Abstract]:Background & objective TAPP and TEP are two main methods of laparoscopic inguinal hernioplasty. However, both of them may have an impact on male reproductive function. Laparoscopic repair of inguinal hernia free of vasectomy has been designed to observe its clinical value and effect. Methods from March 2012 to February 2015, 68 patients undergoing laparoscopic vas deference-free inguinal hernia repair were collected from the Department of General surgery of the first affiliated Hospital of Suzhou University. Postoperative hospitalization days, postoperative pain, postoperative complications, reproductive function and other data, Results the operation time was 59.26 鹵23.50 minutes vs 85.18 鹵14.60 min in TEP group, the postoperative hospitalization time was 1.30 鹵0.54 days vs 2.18 鹵0.52 d, the cost of hospitalization was 11182.43 鹵1038.59 yuan vs 11979.81 鹵1550.24 yuan). There was significant difference between the two groups (P 0.01). Postoperative complications in the vas deference-free group and the TEP group were pain 1.5 vs 1.9, serum swelling 2.9 vs 1.9; hematoma 1.5 vs 1.9; urinary retention 1.5 vs 1.9; scrotum emphysema; seminal cord rupture; foreign body sensation; intestinal obstruction. There was no difference in the incidence of ejaculation dysfunction. There was no significant difference in reproductive function before and after operation in the vas deferens free group (P 0.05). The follow-up period was 2 to 28 months. Conclusion there is no significant difference in complications, recurrence rate and hospitalization cost between laparoscopic vas deference-free inguinal herniorrhaphy and TEP, but the former eliminates the separation of the hernia sac from the vas deferens, thus simplifies the operation. It also protects the vas deferens and spermatic vessels, so it has certain clinical application and further study value.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R656.2

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