腹腔镜下免输精管分离腹股沟疝修补术与腹腔镜完全腹膜外腹股沟疝修补术的对比研究

发布时间：2018-02-20 04:49

本文关键词： 腹股沟疝免输精管分离生殖功能腹腔镜下完全腹膜外腹股沟疝修补　出处：《苏州大学》2015年硕士论文　论文类型：学位论文

【摘要】：背景与目的TAPP与TEP是目前腹腔镜下腹股沟疝修补的两种主流术式。但这两种术式都可能对男性生殖功能造成影响。为了解决这一问题,现已设计施行了腹腔镜下免输精管分离腹股沟疝修补术,为了观察它的临床价值和作用,我们对它和TEP进行了对比研究。方法抽取2012年3月-2015年2月苏州大学附属第一医院普外科进行的68例腹腔镜下免输精管分离腹股沟疝修补术的患者资料。采集手术时间,术后住院天数,术后疼痛,术后并发症,生殖功能情况等数据,与同期进行的53例TEP手术病例资料进行对比分析。结果TEP组的手术时间(59.26±23.50min vs 85.18±14.60min)、术后住院天数(1.30±0.54d vs 2.18±0.52d)、住院费用(11182.43±1038.59元vs 11979.81±1550.24元)较免输精管分离腹股沟疝修补组少,两组间有统计学意义(P0.01)。免输精管分离组与TEP组间的并发症术后疼痛(1.5%vs 1.9%)、血清肿(2.9%vs 1.9%)、血肿(1.5%vs 1.9%)、尿潴留(1.5%vs 1.9%)、阴囊气肿、精索离断、异物感、肠梗阻、射精功能障碍等发生率并无差异。免输精管分离组术前术后的生殖功能无明显差异(P0.05)。随访2-28个月,两组均无复发病例。结论腹腔镜下免输精管分离腹股沟疝修补术与TEP在并发症、复发率及住院费用等无明显差异。但前者免除了疝囊与输精管的分离,因此简化了操作,还保护了输精管和精索血管,因此具有一定的临床应用及进一步探讨的价值。
[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 卤23.50 minutes vs 85.18 卤14.60 min in TEP group, the postoperative hospitalization time was 1.30 卤0.54 days vs 2.18 卤0.52 d, the cost of hospitalization was 11182.43 卤1038.59 yuan vs 11979.81 卤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.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R656.2

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