CAJ | 학술논문

目的比较疝环充填式无张力疝修补术(Rutkow术)与完全腹膜外疝修补术(TEP)治疗腹股沟疝的临床疗效.方法选择腹股沟疝患者353例,其中采用Rutkow术治疗182例(Rutkow术组),采用TEP治疗171例(TEP组).比较两组手术时间,总出血量,术后第1、3天疼痛视觉模拟评分(VAS),近期并发症发生率,住院时间,住院总费用,恢复正常体力活动时间,疝再发率等指标.结果与Rutkow术组比较,TEP组术后第3天VAS低[(2.6±1.4)分比(3.1±1.5)分]、住院时间短[(3.2±2.4)d比(4.3±2.7)d]、恢复正常体力活动时间快[(23.3±17.8)d比(31.0±15.9)d]、术后疝再发率低[1.8％(3/171)比6.6％(12/182)],但手术时间长[(45.6±36.1)min比(35.2±20.5)min]、总出血量多[(27.7±20.4) ml比(15.8±10.7) ml]、住院总费用高[(9029.5±683.4)元比(6782.7±1076.3)元],差异均有统计学意义(P＜ 0.01或＜0.05);两组术后第1天VAS、近期并发症发生率比较差异无统计学意义(P＞0.05).结论与Rutkow术比较,TEP治疗腹股沟疝具有术后疼痛轻、住院时间短、恢复正常体力活动时间快、术后疝再发率低等优势,值得推广.
목적 비교산배충전식무장력산수보술(Rutkow술)여완전복막외산수보술(TEP)치료복고구산적림상료효.방법 선택복고구산환자353례,기중채용Rutkow술치료182례(Rutkow술조),채용TEP치료171례(TEP조).비교량조수술시간,총출혈량,술후제1、3천동통시각모의평분(VAS),근기병발증발생솔,주원시간,주원총비용,회복정상체력활동시간,산재발솔등지표.결과 여Rutkow술조비교,TEP조술후제3천VAS저[(2.6±1.4)분비(3.1±1.5)분]、주원시간단[(3.2±2.4)d비(4.3±2.7)d]、회복정상체력활동시간쾌[(23.3±17.8)d비(31.0±15.9)d]、술후산재발솔저[1.8％(3/171)비6.6％(12/182)],단수술시간장[(45.6±36.1)min비(35.2±20.5)min]、총출혈량다[(27.7±20.4) ml비(15.8±10.7) ml]、주원총비용고[(9029.5±683.4)원비(6782.7±1076.3)원],차이균유통계학의의(P＜ 0.01혹＜0.05);량조술후제1천VAS、근기병발증발생솔비교차이무통계학의의(P＞0.05).결론 여Rutkow술비교,TEP치료복고구산구유술후동통경、주원시간단、회복정상체력활동시간쾌、술후산재발솔저등우세,치득추엄.
Objective To compare the clinical outcome of Rutkow procedure and totally extraperitoneal hernioplasty (TEP) for inguinalhernia.Methods Three hundred and fifty-three patients with inguinal hernia were divided into 2 groups according to the operation method:182 cases underwent Rutkow procedure (Rutkow procedure group) and 171 cases underwent TEP (TEP group).Operative time,overall blood loss,visual analogue score (VAS) on postoperative day 1 and day 3,rate of short-term comphcations,length of hospital stay,total cost,time to full recovery and hernia recurrence rate were compared between the 2 groups.Results TEP group had significantly lower VAS on postoperative day 3 [(2.6 ± 1.4) scores vs.(3.1 ± 1.5) scores],shorter length of hospital stay [(3.2 ± 2.4) d vs.(4.3 ± 2.7) d] and time to full recovery [(23.3 ± 17.8) d vs.(31.0 ± 15.9) d],lower hernia recurrence rate [1.8％(3/171) vs.6.6％ (12/182)],but had longer operative time [(45.6 ± 36.1) min vs.(35.2 ± 20.5) min],more overall blood loss [(27.7 ± 20.4) ml vs.(15.8 ± 10.7) ml],higher total cost [(9029.5 ± 683.4) yuan vs.(6782.7 ± 1076.3) yuan],there were statistical differences between the 2 groups (P ＜ 0.01 or ＜ 0.05).There were no statistical differences in VAS on postoperative day 1 and rate of short-term complications between the 2 groups (P ＞ 0.05).Conclusion TEP is recommendable because of the advantages of less postoperative pain,shorter length of hospital stay,faster to full recovery and lower recurrence rate,and it is worth to utilize in clinic.