腹腔镜腹股沟疝修补术的临床应用(1)
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【摘要】 目的探讨比较腹腔镜腹股沟疝修补术与传统无张力修补术的临床疗效。 方法 回顾分析比较我院同一时期2006年10月至2009年9月行腹腔镜疝修补术81例和237例传统腹股沟疝无张力修补术。其中行IPOM术病例为34例，例次37，行TAPP术病例为41例，例次为45例，而TEP则为6例。结果 在腹腔镜腹股沟疝修补术组中，2例出现腹股沟区疼痛，1例出现腹股沟异物感，无肠粘连引起的临床症状，在传统腹股沟疝无张力修补术中，23例术后出现腹股沟区疼痛，19例术后出现腹股沟区异物感。术后随访1~4年，腹腔镜疝修补术暂发现1例复发，无肠粘连病例，而传统无张力修补术则有3例复发。结论 与传统腹股沟疝无张力修补术比较，两者在复发率上无统计学差异(χ2=0.31，P>0.05)，两者在术后疼痛、异物感等主要并发症上有显著统计学差异(χ2=9.76，P<0.01)。腹腔镜腹股沟疝修补术除具有传统无张力修补术的优点，术后复发率低外，腹腔镜疝修补术更有优势，创伤更少，住院时间更短，术后疼痛、异物感等并发症更少。
【关键词】 腹股沟疝；腹腔镜术；腹腔内网片贴置法
The expression of laparoscopic herniorrhaphy for inguinal hernia
LIU Zhenbang，LIU Hongjie，LIANG Liyuan，et al.
Gastxointestinal Surgery，The First People’s Hospital of Guangzhou,Guangdong 510180,China
【Abstract】 Objective To evaluate the clinical effect between laparoscopic herniorrhaphy(LHR)and tensionfree herniorrhaphy for inguinal hernia.Methods Retrospectively and analyze the clinical datas all from October 2006 to December 2009，81 patients who were repaired by laparoscopic herniorrhaphy for inguinal hernia.And 237 patients were underwent mesh plug tensionfree herniorrhaphy.And34 patients with 37 inguinal hernias were repaired by intraperitoneal onlay mesh(IPOM)，41 patients with 45 were repaired by transabdominal preperitoneal prosthetic(TAPP)，others 6 patients were repaired by totally extraperitoneal prosthesis(TEP).Results 2 patients who were underwent LHR had pain in ingunial hernia area.and only one patient had foreign body sensation in ingunial hernia area.No was found intestinal adhesion.23 patients who were underwent tensionfree herniorrhaphy had pain in ingunial hernia area.And 19 patients had foreign body sensation in ingunial hernia area.After 1~4 year，only one patient was recurred in LHR,and 3 patients was recurred in tensionfree herniorrhaphy.Conclusion Comparion with tensionfree herniorrhaphy,there was no significant different in recurrence(χ2=0.31，P>0.05).There were significant different in pain or foreign body sensation.LHR not only has the virtue in low recurrence rate of tensionfree herniorrhaphy，but also have the advantages of less trauma,complications and so on.
【Key words】 Inguinal hernia； Laparoscopy；IPOM
从1982年Ger[1]等首先施行腹腔镜疝修补术，经腹腔膜前补片植入术(transabdominal preperitoneal repair，TAPP)[2]，到Mckernan与Laws[3]于1993年首先报道完全腹膜外入路腹腔镜下行疝修补术(TEP)，腹腔镜疝修补术越来越成熟 ......
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