CAJ | 학술논문

目的评估腹腔镜完全腹膜外疝修补术(totally extraperitoneal hernia repair,TEP)免钉合、双网片交叠术式的安全性、可靠性,并探讨主要并发症的原因.方法 243腹股沟疝例患者按入院日期的单双号分组,单号为单网片钉合固定组136例,双号为免钉合、双网片交叠组107例,均行TEP修补手术.对手术结果进行t检验或χ2检验.结果本组243例,随访233例,随访率96%.平均随访(28±6)个月,免钉合、双网片交叠组的复发率(1.9%)与钉合固定组(2.9%)比并无增加(P＞0.05);两组间总并发症以及慢性神经痛、感觉异常、阴囊血肿、血清肿、术区感染、睾丸鞘膜积液、大出血、肺炎、尿路感染等各并发症均差异无统计学意义(均P＞0.05).结论腹腔镜完全腹膜外疝修补术免钉合、双网片交叠术式没有增加术后复发率,安全、可靠,可减少因钉合固定所致并发症的发生.
목적 평고복강경완전복막외산수보술(totally extraperitoneal hernia repair,TEP)면정합、쌍망편교첩술식적안전성、가고성,병탐토주요병발증적원인.방법 243복고구산례환자안입원일기적단쌍호분조,단호위단망편정합고정조136례,쌍호위면정합、쌍망편교첩조107례,균행TEP수보수술.대수술결과진행t검험혹χ2검험.결과 본조243례,수방233례,수방솔96%.평균수방(28±6)개월,면정합、쌍망편교첩조적복발솔(1.9%)여정합고정조(2.9%)비병무증가(P＞0.05);량조간총병발증이급만성신경통、감각이상、음낭혈종、혈청종、술구감염、고환초막적액、대출혈、폐염、뇨로감염등각병발증균차이무통계학의의(균P＞0.05).결론 복강경완전복막외산수보술면정합、쌍망편교첩술식몰유증가술후복발솔,안전、가고,가감소인정합고정소치병발증적발생.
Objective To assess the safety and effectiveness of laparoscopically total extraperitoneal (TEP) repair using two mesh cross and overlap without stapler technique and to discuss the cause of main complications. Methods In this study 243 cases of inguinal hernia were randomly divided into two groups. One group underwent two meshes cross and overlap no fixation TEP, the other underwent a single mesh stapling fixation TEP. The average postoperative follow-up was ( 28 ± 6 ) months. For comparing the effect of the two approaches, statistical analysis including the χ2 test and Student's t test was carried out where appropriate. A p value of less than 0. 05 was considered statistically significant. Results The recurrence rate for the mesh no fixation group ( 1.9% ) did not increase when compared to mesh fixation group( 2. 9% ) ( P ＞ 0. 05 ). The overall postoperative complication rate or individual complication rate was not significantly different between the two groups. Conclusions Laparoscopically total extraperitonealrepair(TEP) using two mesh cross and overlap no fixation technique is safe and reliable.