两种无张力疝修补手术治疗复发腹股沟疝的疗效比较

doi:10.3969/j.issn.1006-7795.2018.01.024

首都医科大学学报 ›› 2018, Vol. 39 ›› Issue (1): 138-142.doi: 10.3969/j.issn.1006-7795.2018.01.024

两种无张力疝修补手术治疗复发腹股沟疝的疗效比较

李凯, 许光中, 王桐生, 刘晨, 朱斌

首都医科大学附属北京世纪坛医院普通外科, 北京 100038

收稿日期:2017-02-03 出版日期:2018-01-21 发布日期:2018-01-27
通讯作者: 朱斌 E-mail:binbinzhu99@hotmail.com

Comparison of the effect of two different tension free operations in recurrent inguinal hernia repair

Li Kai, Xu Guangzhong, Wang Tongsheng, Liu Chen, Zhu Bin

Department of General Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China

Received:2017-02-03 Online:2018-01-21 Published:2018-01-27

摘要/Abstract

摘要： 目的比较开放腹膜外腹股沟疝修补术（total extraperitioneal hernoirrhaphy，TEP）和李金斯坦术式（Lichtenstein）两种术式治疗复发腹股沟疝的临床疗效。方法采用回顾性研究方法，收集首都医科大学附属北京世纪坛医院2008年1月至2014年6月行开放TEP（A组25例）和李金斯坦术式（B组23例）治疗复发腹股沟疝48例患者的临床资料，比较两组患者的手术时间、术中出血量、下床活动的时间、住院时间和合并症（尿潴留、切口感染、切口感觉异常或疼痛、血清肿或阴囊水肿、再复发率等）。结果 A、B两组患者年龄、性别、体质量指数（body mass index，BMI）、手术时间、下床活动时间及住院时间比较，差异均无统计学意义（P>0.05）。A组患者术中出血量[（8.2±2.3）mL]少于B组[（23.8±5.5）mL]（P<0.05）；A组总合并症发生率（8%）低于B组（39.1%）（P<0.05）。结论开放腹膜外腹股沟疝修补术治疗复发腹股沟疝效果优于李金斯坦术式，更加安全有效。

关键词: 腹股沟疝, 复发疝, 开放腹膜外腹股沟疝修补术, 无张力疝修补术, 李金斯坦

Abstract: Objective To evaluate the effect of open total extraperitioneal hernoirrhaphy(open TEP) and Lichtenstein tension-free hernioplasty in recurrent inguinal hernia repair.Methods A total of 48 patients presenting as recurrent inguinal hernia from January 2008 to June 2014, who then exposed to either open TEP (group A,n=25) or Lichtenstein (group B,n=23) were retrospectively studied. Outcome was compared between two groups in duration of the operation, blood loss, length of hospital stay (LOS), complications (urinary retention,incisional infection, incisional paresthesia, incisional pain, hematomas, seroma and recurrent hernia).Results There was no statistically significant difference between the two groups in age, sex, body mass index (BMI), duration of the operation, LOS(P>0.05). Statistically significant differences were identified between group A and group B in blood loss[(8.2±2.3)mL vs (23.8±5.5)mL,P<0.05] and total complication (8% vs 39.1%,P<0.05).Conclusion Open TEP is superior to Lichtenstein surgery and more safe and effective for the treatment of recurrent inguinal hernia.

Key words: inguinal hernia, recurrent hernia, open total extraperitioneal hernoirrhaphy (open TEP), tension-free hernioplasty, Lichtenstein

中图分类号:

R656.2⁺1

李凯, 许光中, 王桐生, 刘晨, 朱斌. 两种无张力疝修补手术治疗复发腹股沟疝的疗效比较[J]. 首都医科大学学报, 2018, 39(1): 138-142.

Li Kai, Xu Guangzhong, Wang Tongsheng, Liu Chen, Zhu Bin. Comparison of the effect of two different tension free operations in recurrent inguinal hernia repair[J]. Journal of Capital Medical University, 2018, 39(1): 138-142.

参考文献

[1] 王明刚.腹腔镜经腹腹膜前补片植入术治疗复发性腹股沟疝技术探讨[J].中国实用外科杂志,2015,35(11):1172-1173.
[2] 中华医学会外科学会疝和腹壁外科学组. 成人腹股沟疝、股疝手术治疗方案(修订稿)[J].中华普通外科杂志,2004,19(2):126.
[3] 唐健雄.重视腹壁疝规范化治疗[J].中国实用外科杂志,2014,34(5):381-383.
[4] McKernan J B,Laws H L.Laparoscopic repair of inguinal hernias using a totally extraperitoneal prosthetic approach[J]. Surg Endosc, 1993,7(1):26-28.
[5] 刘威,沈根海,高泉根,等.全腹膜外腹腔镜疝修补术在女性腹股沟疝中的应用[J].实用医学杂志,2016,32(10):1672-1674.
[6] 沈根海,吴国良,王刚,等.腹腔镜全腹膜外腹股沟疝修补术367例[J].实用医学杂志,2015,31(10):1677-1679.
[7] Mathur S, Lin S Y. The learning curve for laparoscopic inguinal hernia repair:a newly qualified surgeon perspective[J].J Surg Res,2016,205(1):246-251.
[8] 李建国,胡旭,郑兴斌,等.完全腹膜外疝修补术Lichtenstein修补术治疗成人腹股沟疝随机对照试验的Meta分析[J].世界华人消化杂志,2015,23(10):1683-1689.
[9] Pisanu A, Podda M, Saba A,et al. Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair[J].Hernia,2015,19(3):355-366.
[10] 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].中国实用外科杂志,2014,34(6):484-486.
[11] Köckerling F, Bittner R, Kuthe A, et al. Laparo-endoscopic versus open recurrent inguinal hernia repair:should we follow the guidelines[J].Surg Endosc, 2016,31(8):3168-3185.
[12] Öberg S, Andresen K, Rosenberg J. Surgical approach for recurrent inguinal hernias:a Nationwide Cohort Study[J].Hernia, 2016,20(6):777-782.
[13] 卢天有,罗海军,李英儒.开放完全腹膜外修补术在治疗腹股沟复发疝中的临床应用[J].中华疝和腹壁外科杂志:电子版,2016,10(3):210-212.
[14] 尚培中, 李晓武,苗建军.腹股沟疝相关解剖学标志与腹腔镜手术规范化操作要点[J].解放军医药杂志,2015,27(5):1-5.
[15] 刘厚生, 廖秋,赵勇.Lichtenstein术在治疗腹股沟疝中的优势[J].首都医科大学学报,2014,35(5):660-662.
[16] 周新红,唐忠斌,曾长江,等.完全性腹膜前无张力疝修补治疗腹股沟复发疝临床分析[J].中华疝和腹壁外科杂志:电子版,2014,8(2):149-151.
[17] Lee S R, Choi S B. The efficacy of laparoscopic intracorporeal linear suture technique as a strategy for reducing recurrences in pediatric inguinal hernia[J].Hernia,2017,21(3):425-433.
[18] Nikkolo C, Lepner U. Chronic pain after open inguinal hernia repair[J].Postgrad Med,2016,128(1):69-75.
[19] 苏福增,王志,张成,等.嵌顿性腹股沟疝合并肾病综合征病人的围手术期处理[J].临床外科杂志,2016,24(4):260-262.

两种无张力疝修补手术治疗复发腹股沟疝的疗效比较

Comparison of the effect of two different tension free operations in recurrent inguinal hernia repair

PDF

可视化

被引次数

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 4

编辑推荐

Metrics

本文评价

[1]	王帆, 靳翠红, 赵凤林, 申英末, 陈杰. 自固定补片与钉合固定补片在巨大腹股沟疝行腹腔镜经腹腹膜前疝修补术中的对比研究[J]. 首都医科大学学报, 2017, 38(6): 911-914.
[2]	刘厚生, 廖秋, 赵勇. Lichtenstein术在治疗腹股沟疝中的优势[J]. 首都医科大学学报, 2014, 35(5): 660-662.
[3]	梁存河;王宇;谭嗣伟;陈志雨. 开放式腹股沟疝无张力修补术1 136例临床分析[J]. 首都医科大学学报, 2010, 31(3): 398-401.
[4]	王明刚;陈杰;刘素君;申英末;包少瑜;朱大伟. 局部神经阻滞麻醉在老年腹股沟疝患者无张力修补术中的应用[J]. 首都医科大学学报, 2008, 29(6): 770-772.