CAJ | 학술논문

目的：对腹腔镜腹股沟疝修补术治疗的超重和肥胖患者与非肥胖患者术后并发症进行回顾性的比较和分析。方法回顾性分析2008年5月至2014年5月,辽宁省抚顺市中心医院完成的腹腔镜腹股沟疝修补术194例；分为超重和肥胖组患者(A 组,BMI ≥25.0 cm/ kg2),和非超重和肥胖组患者(B 组,BMI <25.0 cm/ kg2)；其中 A 组患者行 TEP 术32例,TAPP 术23例；B 组患者行 TEP术77例,TAPP 术62例；对围手术期预后指标、并发症和复发率等进行观察和比较。结果入组时 A组 BMI 和腰围与身高比值(WHtR)较 B 组高(F 值分别为82.7和118.5,P<0.001),TEP 和 TAPP 亚组的 BMI 和 WHtR 值比较,差异无统计学意义( P >0.05)；A 组患者的手术时间( F =15.14,P<0.001)、术后下床活动时间(F=11.53,P<0.001)和术后住院时间(F =124.0,P<0.001)显著延长；A组患者的血清肿发生率显著增高(χ2=5.27,P<0.05)。结论 LIHR 可安全的应用于超重和肥胖患者的腹股沟疝治疗,但手术难度较大,手术时间较长,术后恢复时间长,血清肿的发生率较高；超重和肥胖对 TEP 和 TAPP 患者预后的影响需前瞻性研究进一步证实。
목적：대복강경복고구산수보술치료적초중화비반환자여비비반환자술후병발증진행회고성적비교화분석。방법회고성분석2008년5월지2014년5월,요녕성무순시중심의원완성적복강경복고구산수보술194례；분위초중화비반조환자(A 조,BMI ≥25.0 cm/ kg2),화비초중화비반조환자(B 조,BMI <25.0 cm/ kg2)；기중 A 조환자행 TEP 술32례,TAPP 술23례；B 조환자행 TEP술77례,TAPP 술62례；대위수술기예후지표、병발증화복발솔등진행관찰화비교。결과입조시 A조 BMI 화요위여신고비치(WHtR)교 B 조고(F 치분별위82.7화118.5,P<0.001),TEP 화 TAPP 아조적 BMI 화 WHtR 치비교,차이무통계학의의( P >0.05)；A 조환자적수술시간( F =15.14,P<0.001)、술후하상활동시간(F=11.53,P<0.001)화술후주원시간(F =124.0,P<0.001)현저연장；A조환자적혈청종발생솔현저증고(χ2=5.27,P<0.05)。결론 LIHR 가안전적응용우초중화비반환자적복고구산치료,단수술난도교대,수술시간교장,술후회복시간장,혈청종적발생솔교고；초중화비반대 TEP 화 TAPP 환자예후적영향수전첨성연구진일보증실。
Objective To compare and analyze the complication differences between overweight-obesity patients and normal patients after laparoscopic inguinal hernia repair. Methods A total of 194 inguinal hernia patients were enrolled from May 2008 to May 2014. The patients were divided into two groups (A and B) according to body mass index (BMI). In group A (BMI ≥ 25. 0 kg/ m2 ), 32 cases of TEP and 23 cases of TAPP were performed; and in group B (BMI < 25. 0 kg/ m2 ), 77 cases of TEP and 62 cases of TAPP were performed. And prognostic index, complications and recurrence rates were observed and compared. Results BMI and WHtR values were significantly higher in group A than those in group B at baseline ( F = 82. 7 and 118. 5, respectively; P< 0. 001). There were no significant difference between subgroups of TEP and TAPP (P>0. 05). Operating time (F=15. 14, P<0. 001), time to ambulation after surgery (F=11. 53, P<0. 001) and length of postoperative stay (F = 124. 0, P<0. 001) were significantly longer in group A than those in group B; also, the seroma rate in group A was significantly higher (χ2 = 5. 27, P<0. 05). Conclusion It′s safe to use laparoscopic inguinal hernia repair in overweight and obesity patients. However, it shows that increasing the difficulty of operation, prolonging operative time and recovery time, and having a higher rate of seroma. The prognostic effects of TEP and TAPP treatment on overweight and obesity patients should be confirmed by further perspective studies.