摘要
目的比较腹腔镜与开放腹股沟疝无张力修补术在腹股沟疝合并肝硬化患者中的效果。方法前瞻性性收集青岛大学医学院附属威海市中心医院肝胆、疝与腹壁外科2016年1月至2020年2月收治的腹股沟疝合并肝硬化患者60例,按照随机数字表法分为A、B两组,每组30例。A组患者在全身麻醉下行腹腔镜下经腹腔腹膜前腹股沟疝无张力修补术(TAPP),B组患者局部麻醉下行开放腹股沟疝无张力修补术(李金斯坦手术),观察和比较两组患者一般临床资料、术后切口并发症发生率、血清肿发生率、术后住院时间、慢性疼痛发生率、复发率等指标。每例患者随访至术后6个月,随访时间截止2020年9月。结果A组30例患者中,男性26例,女性4例,年龄(58.8±12.8)岁,Child-Pugh分级评分(7.20±1.35)分,腹股沟疝病程8.0(3.0,19.5)个月,阴囊疝11例;B组30例患者中,男性28例,女性2例,年龄(61.7±11.1)岁,Child-Pugh分级评分(7.50±1.14)分,腹股沟疝病程9.5(4.8,24.0)个月,阴囊疝14例;两组一般资料比较,差异均无统计学意义(均P>0.05)。A组无术后切口并发症患者,B组出现切口并发症6例,两组比较差异有统计学意义(P<0.05);A组术后发生血清肿患者6例,B组术后发生血清肿患者4例,两组比较差异无统计学意义(P>0.05);A组术后住院时间(4.1±1.5)d,少于B组术后住院时间(5.9±2.1)d,两组比较差异有统计学意义(P<0.05);A组术后慢性疼痛患者1例,少于B组慢性疼痛8例,两组比较差异有统计学意义(P<0.05);A组无术后复发患者,B组术后复发患者2例,两组比较差异无统计学意义(P>0.05)。结论腹腔镜与开放无张力修补术都是安全可行的,腹腔镜腹股沟疝在减少切口局部并发症、缩短住院术后时间、减少术后慢性疼痛方面有明显优势。
Objective To explore the effects of laparoscopic versus open tension-free inguinal hernia repair for patients with liver cirrhosis and inguinal hernia.Methods From January 2016 to February 2020,60 patients with liver cirrhosis and inguinal hernia admitted to Weihai Central Hospital were prospectively collected,and divided into group A and group B by the random number table method,with 30 cases in each group.Group A underwent laparoscopic transabdominal preperitoneal hernioplasty(TAPP)under general anesthesia,and group B open inguinal hernia repair(Lichtenstein surgery)under local anesthesia.The incidences of postoperative incision complications and seroma,postoperative hospital stays,incidences of chronic pain,recurrence rates,etc.were observed and compared between these two groups.Every patient was followed up until 6 months after the operation.The follow up ended in September 2020.Results There were 26 males and 4 females in group A,who were(58.8±12.8)years old and whose Child-Pugh staging score and disease course were(7.20±1.35)and 8.0(3.0,19.5)months,with 14 cases of scrotocele;there were 28 males and 2 females in group B,who were(61.7±11.1)years old and whose Child-Pugh staging score and disease course were(7.50±1.14)and 9.5(4.8,24.0)months,with 14 cases of scrotocele;there were no statistical differences in the above data between these two groups(all P>0.05).No case had postoperative incision complications in group A,and 6 in group B(P<0.05).Six cases occurred postoperative seroma in group A,and 4 in group B(P>0.05).The postoperative hospital stay was(4.1±1.5)days in group A,and was(5.9±2.1)days in group B(P<0.05).One case got postoperative chronic pain in group A,and 8 in group B(P<0.05).No case recurred after the operatin in group A,and 2 in group B(P>0.05).Conclusion Both laparoscopic and open tension-free inguinal hernia repair are safe and feasible,and laparoscopic inguinal hernia repair has obvious advantages in reducing local incision complications and postoperative chronic pain and shortening hospitalization time.
作者
孙丕绛
蔡超
于燕华
张守响
皮明润
侯海鹏
李传宝
牛家增
张磊
赵学智
崔夕军
Sun Pijiang;Cai Chao;Yu Yanhua;Zhang Shouxiang;Pi Mingrun;Hou Haipeng;Li Chuanbao;Niu Jiazeng;Zhang Lei;Zhao Xuezhi;Cui Xijun(Department of Hepatobiliary and Hernia Surgery,Weihai Central Hospital Affiliated to Medical College,Qingdao University,Weihai 264400,China)
出处
《国际医药卫生导报》
2021年第17期2671-2675,共5页
International Medicine and Health Guidance News
基金
吴阶平医学基金会临床科研专项资助课题(320.675018402)。
关键词
腹股沟疝
肝硬化
腹腔镜
疝修补术
Inguinal hernia
Liver cirrhosis
Laparoscope
Hernia repair
