摘要
目的:采用Meta分析方法比较腹腔镜全腹膜外腹股沟疝修补术(TEP)采用医用胶与钉合固定补片的疗效。方法:计算机检索PubMed、Embase、The Cochrane Library、Web of Science等外文数据库及中国知网、万方、维普、中国生物医学文献等中文数据库,时间限定为2018年10月前。提取数据后采用RevMan 5.3软件进行Meta分析。结果:最终纳入9项研究,共986例患者,其中医用胶组491例,钉合固定组495例。Meta分析结果显示,与钉合固定组相比,医用胶组术后第1天疼痛视觉模拟评分(VAS)较低(MD=-0.99,95%CI=-1.58^-0.41,P<0.001),术后VAS较低(MD=-1.71,95%CI=-1.84^-1.57,P<0.00001),术后麻木或异物感较少(OR=0.23,95%CI=0.07~0.75,P<0.05)。两组术后血清肿(OR=1.77,95%CI=0.99~3.16,P=0.05)、术后感染(OR=1.77,95%CI=0.51~6.19,P>0.05)、术后尿潴留(OR=0.69,95%CI=0.20~2.32,P>0.05)发生率差异均无统计学意义。结论:腹腔镜全腹膜外腹股沟疝修补术中采用医用胶固定补片,术后第1天VAS评分、术后VAS评分、麻木或异物感优于钉合固定。
Objective:To compare the clinical effectiveness of mesh fixation with medical glue and staple in laparoscopic total extraperitoneal inguinal hernia repair with meta-analysis.Methods:Foreign databases such as PubMed,Embase,The Cochrane Library and Web of Science,as well as Chinese databases such as CNKI,Wanfang,Weipu and China Biology Medicine disc were searched,the literatures were limited before Oct.2018.The Review manager software(version 5.3)was used for statistical analysis.Results:Nine studies were finally included involving 986 patients,of whom 491 in the medical glue group and 495 in the staple group.Meta-analysis results showed that the pain score(visual analogue scale,VAS)on the first day after surgery was lower in the medical glue group(MD=-0.99,95%CI=-1.58^-0.41,P<0.001),the pain score was lower in the medical glue group(MD=-1.71,95%CI=-1.84^-1.57,P<0.00001)and numbness or foreign body sensation was less compared with the staple group(OR=0.23,95%CI=0.07~0.75,P<0.05).There was no significant difference in the postoperative seroma(OR=1.77,95%CI=0.99~3.16,P=0.05),postoperative infection(OR=1.77,95%CI=0.51~6.19,P>0.05)or postoperative urinary retention(OR=0.69,95%CI=0.20~2.32,P>0.05)between the two groups.Conclusions:According to available evidence,there are some findings as follows:medical glue fixation is better than stapling fixation in laparoscopic inguinal hernia repair because the VAS score on the first day after surgery,the VAS score after surgery,numbness or foreign body sensation after surgery are better than stapling fixation.
作者
侯建忠
樊友本
伍波
HOU Jian-zhong;FAN You-ben;WU Bo(The Sixth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200233,China)
出处
《腹腔镜外科杂志》
2019年第7期519-525,共7页
Journal of Laparoscopic Surgery
关键词
疝
腹股沟
全腹膜外
疝修补术
腹腔镜检查
医用胶
钉合固定
Hernia,inguinal
Totally extraperitoneal
Herniorrhaphy
Laparoscopy
Medical glue
Stapling fixation
