单孔腹腔镜全腹膜外操作与开放式腹股沟疝无张力修补术的对比研究

发布时间：2018-04-22 21:16

本文选题：腹股沟疝 + 单孔腹腔镜修补　；参考：《岭南现代临床外科》2017年02期

【摘要】：目的比较单孔腹腔镜全腹膜外操作与开放式腹股沟疝无张力修补术的临床治疗效果。方法回顾性分析我院2015年1月~2015年6月收治的50例男性单侧腹股沟疝患者的临床资料,年龄18~63岁,中位年龄37岁,所有患者均签署知情同意书,符合医学伦理学规定。患者术前均经超声及临床体格检查,确诊为腹股沟疝。21例行单孔腹腔镜全腹膜外腹股沟疝无张力修补术,29例行开放无张力疝修补术治疗,比较两种术式的手术时间、术中出血量、术后住院时间、术后并发症、术后24小时及慢性疼痛(1月以上)、总住院费用等临床疗效。结果单孔腹腔镜组手术时间、术中出血量、术后平均住院时间及术后24小时疼痛率显著低于开放组,差异有显著性(P0.05);而在总住院费用方面,开放式腹股沟疝无张力修补术组显著低于SILS-TEP组,差异有显著性,有统计学意义(P0.05);而二者在慢性疼痛(1月以上)和术后并发症方面没有显著性差异(P0.05)。结论采用单孔腹腔镜全腹膜外腹股沟疝无张力修补术的患者术后恢复较好,临床效果明显优于开放性无张力修补术。
[Abstract]:Objective to compare the clinical effect of single-hole laparoscopic total extraperitoneal operation and open inguinal hernia tension-free repair. Methods the clinical data of 50 male patients with unilateral inguinal hernia admitted in our hospital from January 2015 to June 2015 were retrospectively analyzed. The age was 1863 years old and the median age was 37 years. All the patients signed informed consent, which was in accordance with the regulations of medical ethics. All the patients were diagnosed as inguinal hernia by ultrasonography and physical examination before operation. Twenty-one patients were diagnosed as inguinal hernia by single hole laparoscopic total extraperitoneal inguinal hernia tension-free repair and 29 patients were treated with open tension-free hernia repair. Intraoperative bleeding, postoperative hospital stay, postoperative complications, postoperative 24 hours and chronic pain (more than one month, total hospital costs, and other clinical effects). Results the time of operation, the amount of blood lost during operation, the average hospitalization time and the pain rate of 24 hours after operation in the single hole laparoscopic group were significantly lower than those in the open group, the difference was significant (P 0.05), but the total hospitalization cost was lower than that in the open group. The open inguinal hernia tension-free repair group was significantly lower than that of SILS-TEP group (P 0.05), but there was no significant difference in chronic pain (more than one month) and postoperative complications (P 0.05). Conclusion the patients with total extraperitoneal inguinal hernia tension-free repair by single hole laparoscopy have a better recovery and the clinical effect is better than that of open tension-free hernioplasty.
【作者单位】：南方医科大学;
【分类号】：R656.21

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