经腹腹膜前疝修补术与全腹膜外疝修补术治疗双侧腹股沟疝的临床研究

胡辉

（商州区人民医院普外科，陕西 商洛，726000）

浏览次数：141次 下载次数：413次

摘要：

目的 探讨经腹腹膜前疝修补术（TAPP）与全腹膜外疝修补术（TEP）治疗双侧腹股沟疝的临床疗效。方法 将我院收治 的84 例双侧腹股沟疝患者按照手术方式分为TAPP 组和TEP 组，各42 例。比较两组患者临床治疗效果。结果 两组患者的手 术有效率、并发症总发生率、复发率、术中出血量、VAS 评分、疼痛持续时间、术后排气时间比较，无显著差异（P>0.05）；TAPP 组术中隐匿疝发现率明显高于TEP 组（P<0.05）。TEP 组手术时间、治疗费用明显优于TAPP 组（P<0.05）。结论 两种术式均为 治疗双侧腹股沟疝的有效术式，临床可根据患者具体情况选择适合的术式。

关键词：经腹腹膜前疝修补术；全腹膜外疝修补术；双侧腹股沟疝；临床研究

中图分类号：R656.21文献标志码：A文章编号：2096-1413(2018)01-0055-02

Clinical study of transabdominal preperitoneal hernia repair and total extraperitoneal hernia repair in bilateral inguinal hernia
HU Hui
（General Surgery Department, the People``s Hospital of Shangzhou District, Shangluo 726000, China）

ABSTRACT: Objective To investigate the clinical efficacy of transabdominal preperitoneal hernia repair (TAPP) and total extraperitoneal hernia repair (TEP) in bilateral inguinal hernia. Methods Eighty-four patients with bilateral inguinal hernia admitted in our hospital were selected as the study subjects, and divided into TAPP group and TEP group in accordance with the surgical approach, with 42 cases in each group. The clinical effects of the two groups were observed and compared. Results There were no significant differences in the operative efficiency, total incidence of postoperative complication, recurrence rate, the intraoperative bleeding, VAS score, duration of pain, and postoperative exhaust time between the two groups (P>0.05). The discovery rate of occult hernia in the TAPP group was significantly higher than that in the TEP group (P<0.05). The operation time, cost of treatment in the TEP group were significantly better than those in the TAPP group (P<0.05). Conclusion Both surgical procedures are effective in the treatment of bilateral inguinal hernia, the appropriate surgical procedures can be selected according to the specific circumstances of patients in clinic.
KEYWORDS: transabdominal preperitoneal hernia repair; total extraperitoneal hernia repair; bilateral inguinal hernia; clinical study

参考文献：
[1] 刘宁,吕云福,陈一明,等.经腹腹膜前疝修补术与全腹膜外疝修补术治疗双侧腹股沟疝的效果比较[J].广东医学,2016,37(9):1362-1365.
[2] 张云,郝晓晖,李健文,等.腹腔镜腹股沟疝修补术治疗老年腹股沟疝的临床疗效[J].中华消化外科杂志,2016,15(10):967-971.
[3] 中华医学会外科学分会疝和腹壁外科学组.成人腹股沟疝诊疗指南(2014 年版)[J].浙江医学,2014,52(15):484-486.
[4] 李亮.实用腹股沟疝外科学[M].西安:世界图书出版西安有限公司,2014.
[5] 王桐生,丁磊,赵爱民,等.腹腔镜下全腹膜外腹股沟疝修补术与经正中线切口腹膜前腹股沟疝修补术的比较研究[J].中国微创外科 杂志,2016,16(2):118-121.
[6] 费昱达,曾玉剑,孙亮,等.全腹膜外与经腹膜腹腔镜腹股沟疝修补 术治疗网塞型补片修补术后复发的体会[J].重庆医学,2016,45(2):255-256.
[7] 王祥龙.腹腔镜腹膜前疝修补术与Lichtenstein 平片疝修补术治疗腹股沟疝的疗效比较[J].中国普通外科杂志,2016,25(4):587- 591.
[8] 李奎,孙亮,舒若,等.腹腔镜下腹膜前修补术治疗双侧腹股沟疝17例[J].中国微创外科杂志,2015,21(6):533-535.
[9] 燕涛,侯亚峰,程晓剑,等.手术入路选择对腹腔镜腹股沟疝修补术临床疗效及安全性的影响[J].安徽医药,2015,19(7):1348-1350.