CAJ | 학술논문

目的：探讨完全腹膜外疝修补术（TEP）与经腹腹膜前疝修补术（TAPP）的临床疗效。方法回顾性分析2010年1月至2013年5月，成都军区昆明总医院收治的腹股沟疝患者216例，均行TAPP或TEP。比较二组患者的手术后疼痛持续时间、并发症及复发情况、住院时间及住院费用。结果 TAPP和TEP组术后疼痛持续时间（｜Z｜＝0．563，P＝0．574）、术后住院时间（｜Z｜＝0．497，P＝0．619）的比较差异均无统计学意义，术后TAPP组复发（对侧复发）1例，TEP组无复发，差异无统计学意义（χ2＝0．718，P＝0．397）；TEP组并发皮下气肿1例，占全部TEP患者总数的1．11％，TAPP组无气肿发生；TAPP组住院费用（8908±611元）低于 TEP组（9123±580元），差异有统计学意义（F＝24．266，P＝0．003）。结论 TAPP与TEP在临床疗效上无差别，但在住院费用上，TAPP相较比TEP稍少，可依据患者经济水平、意愿以及术者水平等综合选择不同的手术方式。
목적：탐토완전복막외산수보술（TEP）여경복복막전산수보술（TAPP）적림상료효。방법회고성분석2010년1월지2013년5월，성도군구곤명총의원수치적복고구산환자216례，균행TAPP혹TEP。비교이조환자적수술후동통지속시간、병발증급복발정황、주원시간급주원비용。결과 TAPP화TEP조술후동통지속시간（｜Z｜＝0．563，P＝0．574）、술후주원시간（｜Z｜＝0．497，P＝0．619）적비교차이균무통계학의의，술후TAPP조복발（대측복발）1례，TEP조무복발，차이무통계학의의（χ2＝0．718，P＝0．397）；TEP조병발피하기종1례，점전부TEP환자총수적1．11％，TAPP조무기종발생；TAPP조주원비용（8908±611원）저우 TEP조（9123±580원），차이유통계학의의（F＝24．266，P＝0．003）。결론 TAPP여TEP재림상료효상무차별，단재주원비용상，TAPP상교비TEP초소，가의거환자경제수평、의원이급술자수평등종합선택불동적수술방식。
Objective To investigate the clinical effect of totally extraperitoneal (TEP ) and transabdominal preperitoneal laparoscopic inguinal hernia repair (TAPP ).Methods 21 6 patients with inguinal hernia who underwent either TAPP or TEP in General Hospital of Chengdu Military Region Kunming from January 201 0 to May 201 3 were retrospectively analyzed.Both patient-groups were compared with duration of postoperative pain,cases of complications and recurrence,postoperative hospitalization stay and costs.Results There was no statistically significant difference between TAPP and TEP in duration of postoperative pain (|Z| =0.563,P=0.574),and in postoperative hospitalization stay (|Z| =0.497,P=0.61 9).One case each of subcutaneous emphysema and recurrence (in contralateral)were occurred in TEP group,none was in TAPP group(χ2 =0.71 8,P=0.397).In terms of hospitalization costs,TAPP cost less than TEP costs,group TAPP spent an average of less than group TEP(F=24.266,P=0.003).Conclusions It seems no difference in clinical curative effect between TAPP and TEP,but TAPP costs less than TEP. That indicated patients who want to take an ideal operation about laparoscopic inguinal herniorrhaphy can make a comprehensive decision on the basis of their economic level and their own intention,as well as experience of surgeon.