CAJ | 학술논문

目的：探讨分析3DMAX补片免固定技术在腹腔镜完全腹膜外疝修补术中的应用。方法：将60例腹股沟疝患者随机分为3DMAX补片加免固定组（A组）、普通补片加医用胶固定组（B组）及普通补片加螺钉固定组（C组），均行腹腔镜完全腹膜外腹股沟疝修补术。观察比较三组患者手术时间、术中出血量、术后并发症的发生情况、复发率以及术后24小时和1个月的患侧腹股沟区的疼痛情况，疼痛情况采用视觉模拟评分（VAS）评估。结果：三组患者均顺利完成手术，术后均无复发，3DMAX补片加免固定组手术时间短、出血量少、术后并发症发生率低，其差异均有统计学意义（ P＜0.05）；而疼痛评分明显低于B组和C组，其差异有统计学意义（P＜0.05）。结论：在腹腔镜下完全腹膜外腹股沟疝修补术中采用3DMAX补片免固定技术切实可行，具有操作简便，手术时间短，术中出血少等优点，且在减轻术区不适感及疼痛方面有显著优势，并不增加复发率。
목적：탐토분석3DMAX보편면고정기술재복강경완전복막외산수보술중적응용。방법：장60례복고구산환자수궤분위3DMAX보편가면고정조（A조）、보통보편가의용효고정조（B조）급보통보편가라정고정조（C조），균행복강경완전복막외복고구산수보술。관찰비교삼조환자수술시간、술중출혈량、술후병발증적발생정황、복발솔이급술후24소시화1개월적환측복고구구적동통정황，동통정황채용시각모의평분（VAS）평고。결과：삼조환자균순리완성수술，술후균무복발，3DMAX보편가면고정조수술시간단、출혈량소、술후병발증발생솔저，기차이균유통계학의의（ P＜0.05）；이동통평분명현저우B조화C조，기차이유통계학의의（P＜0.05）。결론：재복강경하완전복막외복고구산수보술중채용3DMAX보편면고정기술절실가행，구유조작간편，수술시간단，술중출혈소등우점，차재감경술구불괄감급동통방면유현저우세，병불증가복발솔。
objective To discuss and analysis the application of 3D-MAX mesh without fixation in laparoscopic total extraperitoneal in-guinal hernioplasty. Method A total of 60 patients with inguinal hernia who accepted TEP were enrolled including 20 cases of 3DMAX mesh without fixation (group A)、20 cases of mesh fixation with medical glue(group B)and 20 cases of mesh fixation with staple(group C). The difference of surgical time,amount of bleeding,complication occurrence,postoperative pain scale and hernia recurrence rate in three groups were compared. Results All patients were operated successfully without recurrence within postoperative period. There were significant differ-ence between Group A and Group B/C with surgical time,amount of bleeding,complication occurrence( P<0. 05). Group A demonstrated a lower pain scale after operation,and significant difference was found between Group A and Group B/C(P<0. 05). Conclusion The applica-tion of 3DMAX mesh without fixation in laparoscopictotally extraperitoneal inguinal hernia repair is safe and feasibl with less complication and low rate of recurrenc . had more significant advantages on postoperative pain than the ordinary plain film fixed by staple and adhesive.