CAJ | 학술논문

目的探讨经腹腔途径腹膜前补片置入术(TAPP)治疗嵌顿性腹股沟疝的安全性、有效性及优势.方法将124例成年嵌顿性腹股沟疝患者按随机配对法分为两组,观察组56例,采用腹腔镜下复位+TAPP治疗;对照组68例,采用切开复位+无张力疝修补术治疗.记录两组手术时间、住院时间、下床活动时间、住院费用、复发率及并发症情况,并进行统计学分析.结果观察组所有病例均在腹腔镜下完成手术,无中转开放手术.观察组手术时间、住院时间、下床活动时间均短于对照组[(37.52±7.78)min比(44.23±11.32) min、(4.53±0.89)d比(6.85±2.03)d、(9.30±2.65)h比(12.63±3.97) h],差异有统计学意义(P＜0.05).观察组住院费用多于对照组[(9 324±599)元比(7203±507)元],差异有统计学意义(P＜0.05).两组并发症发生率比较差异无统计学意义(P＞0.05).术后随访1年,观察组无复发,对照组有1例复发,两组复发率比较差异无统计学意义(P＞0.05).结论 TAPP治疗嵌顿性腹股沟疝微创、恢复快,是安全有效的,住院费用略高,复发率与无张力疝修补术相当.
목적 탐토경복강도경복막전보편치입술(TAPP)치료감돈성복고구산적안전성、유효성급우세.방법 장124례성년감돈성복고구산환자안수궤배대법분위량조,관찰조56례,채용복강경하복위+TAPP치료;대조조68례,채용절개복위+무장력산수보술치료.기록량조수술시간、주원시간、하상활동시간、주원비용、복발솔급병발증정황,병진행통계학분석.결과 관찰조소유병례균재복강경하완성수술,무중전개방수술.관찰조수술시간、주원시간、하상활동시간균단우대조조[(37.52±7.78)min비(44.23±11.32) min、(4.53±0.89)d비(6.85±2.03)d、(9.30±2.65)h비(12.63±3.97) h],차이유통계학의의(P＜0.05).관찰조주원비용다우대조조[(9 324±599)원비(7203±507)원],차이유통계학의의(P＜0.05).량조병발증발생솔비교차이무통계학의의(P＞0.05).술후수방1년,관찰조무복발,대조조유1례복발,량조복발솔비교차이무통계학의의(P＞0.05).결론 TAPP치료감돈성복고구산미창、회복쾌,시안전유효적,주원비용략고,복발솔여무장력산수보술상당.
Objective To investigate the security and validity of transabdominal preperitoneal prosthetic (TAPP) in treatment of incarcerated hernia.Methods One hundred and twenty-four patients with incarcerated hernia were divided into 2 groups by random pair method:observation group with treatment of laparoscopic reposition and TAPP (56 cases) and control group with treatment of open reduction and tension-free hernioplasty (68 cases).The operative time,hospital stay,bed time,hospital costs,recurrence rate and complication were compared between the 2 groups.Results All patients in observation group were received laparoscopic surgery successfully.The operation time,hospital stay,bed time in observation group were significandy shorter than those in control group [(37.52 ± 7.78) min vs.(44.23 ± 11.32) min,(4.53 ± 0.89) d vs.(6.85 ± 2.03) d,(9.30 ± 2.65) h vs.(12.63 ± 3.97) h],there were statistical differences (P ＜0.05).The hospital costs in observation group was significandy higher than that in control group [(9 324 ± 599) yuan vs.(7 203 ± 507) yuan],there was statistical difference (P ＜ 0.05).There was no statistical difference in complication rate between the 2 groups (P ＞ 0.05).Follow-up 1 year,there was no recurrence patient in observation group and 1 patient was recurrence in control group,there was no statistical difference between the 2 groups (P ＞ 0.05).Conclusions TAPP is safe and effective with advantages of mini-invasion,quicker recovery but more hospital costs in treatment of incarcerated hernia.The recurrence rate of TAPP is similar to tension-free hernioplasty.