经腹腔镜与开放式疝修补手术的随机对照研究

张杰; 周少波; 褚亮; 张昕

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

经腹腔镜与开放式疝修补手术的随机对照研究

张杰 , 周少波 , 褚亮 , 张昕

文章导航 > 蚌埠医学院学报 > 2012, 36 > 8: (898-900)

引用本文:

Citation:

经腹腔镜与开放式疝修补手术的随机对照研究

1.
蚌埠医学院第二附属医院普外科, 安徽, 蚌埠, 233004

作者简介: 张杰(1969-)，男，副主任医师

基金项目:

A comparative study of treatment inguinal hernia with laparoscopic hernia repair and open hernia repair

1.
Department of General Surgery, The Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233040, China

摘要: 目的：比较经腹腔镜与开放式4种术式修补腹股沟疝的效果。方法：将连续100例NyhusⅠ～Ⅲ型原发性腹股沟疝患者随机均分为4组，Ⅰ组行开放式腹膜前修补术，Ⅱ组行Lichtenstein无张力疝修补术，Ⅲ组行腹腔镜经腹腔腹膜前补片植入术(TAPP)，Ⅳ组行腹腔镜全腹膜外补片修补术(TEP)。结果：Ⅲ、Ⅳ组患者手术时间均长于Ⅰ、Ⅱ组(P0.01)，Ⅰ组手术时间长于Ⅱ组(P0.05)。Ⅰ、Ⅱ组患者术后6 h疼痛均强于Ⅳ组(P0.01和P0.05)。Ⅲ、Ⅳ组中各1例中转开腹手术。经腹腔镜手术恢复工作时间显著快于Ⅰ、Ⅱ组(P0.01)。结论：TEP和TAPP治疗腹股沟疝的效果相似，较开放式修补术后疼痛少，恢复快。
- 腹股沟疝 /
- 腹腔镜术 /
- 腹膜前修补术 /
- 无张力疝修补术
Abstract: Objective:To compare the effects of four different repairs on inguinal hernia.Methods:One hundred cases with primary inguinal hernia of NyhusⅠⅢ were randomly divided into four groups.Group Ⅰwere treated with open properitoneal repair,group Ⅱ were treated with Lichtenstein tension-free repair,group Ⅲ were treated with transabdominal properitoneal(TAPP) repair and group Ⅳ were treated with laparoscopic totally extraperitoneal(TEP) repair.Results:The operative time of group Ⅲ and Ⅳ were longer than that of group Ⅰ and Ⅱ(P0.01).Compared with group Ⅱ,the operative time of groupⅠwas long(P0.05).Postoperative pain of group Ⅰ and Ⅱwere stronger than that of group Ⅳ within 24 hours after operation(P0.01 and P0.05).One case in group Ⅲ and one in group Ⅳ conversed to open procedure.The activity time of cases treated with laparoscopic operation were significantly shorter than that of group Ⅰ and Ⅱ(P0.01).Conclusions:The effects of TEP and TAPP are similar.Laparoscopic hernia repair is less postoperative pain and fast recovery.
- inguinal hernia /
- laparoscopic operation /
- properitoneal repair /
- tension-free hernia repair

[1]	Stengel D,Bauwens K,Ekkernkamp A.Recurrence risks in randomized trials of laparoscopic versus open inguinal hernia repair:to pool or not to pool(this is not the question)[J].Arch Surg,2004,389(6):492-498.
[2] Johansson B,Hallerbck B,Glise H,et al.Laparoscopic mesh versus open preperitoneal mesh versus conventional technique for inguinal hernia repair:a randomized multicenter trial[J].Ann Surg,1999,230(2):225-231.
[3] 郑民华.腹腔镜在腹部非胆囊手术中的应用[J].中国实用外科杂志,2004,24(1):27-29.
[4] Kurzer M,Belsham PA,Kark AE.Prospective study of open preperitoneal mesh repair for recurrent inguinal hernia[J].Br J Surg,2002,89(1):90-93.
[5] MRC Laparoscopic Groin Hernia Trial Group.Laparoscopic versus open repair of groin hernia:randomized comparison[J].Lancet,1999,354(9174):185-190.
[6] Beets GL,Dirksen CD,Go PM,et al.Open or laparoscopic preperitoneal mesh repair for recurrent inguinal hernia? A randomized controlled trial[J].Surg Endosc,1999,13(4):323-327.
[7] Hindmarsh AC,Cheong E,Lewis MP,et al Attendance at a pain clinic with severe chronic pain after open and laparoscopic inguinal hernia repairs[J].Br J Surg,2003,90(9):1152-1154.
[8] Schrenk P,Woisetschlger R,Rieger R,et al.Prospective randomized trial comparing postoperative pain and return to physical activity after transabdominal preperitoneal,total preperitoneal or Shouldice technique for inguinal hernia repair[J].Br J Surg,1996,83(11):1563-1566.
[9] Memon MA,Cooper NJ,Memon B,et al.Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair[J].Br J Surg,2003,90(12):1479-1492.
[10] Heikkinen T,Haukipuro K,Leppala J,et al.Total costs of laparoscopic and lichtenstein inguinal hernia repairs:a randomized prospective study[J].Surg Laparosc Endosc,1997,7(1):1-5.

[1]	韩凯 , 贲大刚 , 张杰 . 疝环充填式无张力修补术后异时性再发腹股沟疝11例临床分析. 蚌埠医学院学报, 2011, 36(7): 751-752.
[2]	陈传国 , 杨卫富 , 戴象君 . 善释补片在腹膜前股疝无张力修补术中的应用. 蚌埠医学院学报, 2013, 37(4): 436-437.
[3]	胡霜久 , 查润生 . 疝环填充式无张力疝修补术在老年腹股沟疝中的应用. 蚌埠医学院学报, 2008, 33(3): 319-321.
[4]	张玉梅 . 充填式无张力疝修补术72例围手术期护理体会. 蚌埠医学院学报, 2010, 35(9): 965-966.
[5]	张尊庶 , 孙弢 , 张超 . 腹腔镜下经腹腹膜前疝修补术结合快速康复模式在腹股沟疝病人中的应用. 蚌埠医学院学报, 2022, 47(5): 645-647. doi: 10.13898/j.cnki.issn.1000-2200.2022.05.022
[6]	金雄伟 , 张浩 , 梁江 , 李宏帅 . 免充气与充气单孔腹腔镜下完全腹膜外腹股沟疝修补术的临床效果比较. 蚌埠医学院学报, 2019, 44(2): 177-179. doi: 10.13898/j.cnki.issn.1000-2200.2019.02.011
[7]	罗晔哲 , 林素琼 . 完全腹膜外腹腔镜疝修补术在下腹部手术史病人中的可行性研究. 蚌埠医学院学报, 2022, 47(11): 1560-1563. doi: 10.13898/j.cnki.issn.1000-2200.2022.11.019
[8]	张舒龙 , 朱勇 . 腹腔镜胃十二指肠溃疡穿孔修补术临床疗效分析. 蚌埠医学院学报, 2014, 38(1): 83-85.
[9]	范建灵 , 张宁芝 , 肖红 , 宛杨 , 张静 , 王晖 . 腹腔镜下盆腔腹膜阴道成形术的临床应用. 蚌埠医学院学报, 2008, 33(4): 456-457.
[10]	花学美 , 陈宏平 . 经腹膜后腹腔镜肾囊肿去顶术19例护理体会. 蚌埠医学院学报, 2010, 35(9): 954-956.
[11]	靳丽 . 妇科腹腔镜手术围手术期护理. 蚌埠医学院学报, 2012, 36(11): 1380-1381.
[12]	赵云 . 妇科腹腔镜手术的护理配合. 蚌埠医学院学报, 2006, 31(2): 199-200.
[13]	杭群 , 姜从桥 . 腹腔镜直肠癌根治术36例. 蚌埠医学院学报, 2012, 36(9): 1090-1092.
[14]	宋坤 , 于江涛 , 王军 , 宁长青 , 王学究 , 张正涛 . 完全腹膜外腹腔镜及开放式无张力腹股沟疝修补术的比较. 蚌埠医学院学报, 2014, 39(9): 1180-1181,1184.
[15]	王才智 , 晋茂生 , 郭才 , 凌斌 . 腹腔镜手术治疗输卵管妊娠30例. 蚌埠医学院学报, 2005, 30(2): 137-138.
[16]	张爱英 . 腹腔镜手术治疗妇科疾病100例临床分析. 蚌埠医学院学报, 2007, 32(3): 328-330.
[17]	桑学梅 , 陈子云 , 唐桂娥 , 翟敬芳 , 马娟 . 腹腔镜辅助阴式子宫切除术32例临床分析. 蚌埠医学院学报, 2006, 31(4): 370-372.
[18]	王才智 , 何玉 , 申庆文 , 晋茂生 . 腹腔镜辅助子宫肌瘤剔除术的临床应用研究. 蚌埠医学院学报, 2010, 35(9): 887-888.
[19]	张锋 . Supreme喉罩在腹腔镜胆囊切除术中的应用. 蚌埠医学院学报, 2015, 40(2): 207-209. doi: 10.13898/j.cnki.issn.1000-2200.2015.02.023
[20]	欧松柏 , 吴浩瀚 . 腹腔镜胆囊切除术中出血及结石漏入腹腔的处理. 蚌埠医学院学报, 2005, 30(4): 347-347.

点击查看大图

计量

文章访问数: 2267
HTML全文浏览量: 238
PDF下载量: 322
被引次数: 0

经腹腔镜与开放式疝修补手术的随机对照研究

作者简介: 张杰(1969-)，男，副主任医师

1. 蚌埠医学院第二附属医院普外科, 安徽, 蚌埠, 233004

收稿日期: 2012-02-24
网络出版日期: 2012-08-15

基金项目:

关键词:

摘要: 目的：比较经腹腔镜与开放式4种术式修补腹股沟疝的效果。方法：将连续100例NyhusⅠ～Ⅲ型原发性腹股沟疝患者随机均分为4组，Ⅰ组行开放式腹膜前修补术，Ⅱ组行Lichtenstein无张力疝修补术，Ⅲ组行腹腔镜经腹腔腹膜前补片植入术(TAPP)，Ⅳ组行腹腔镜全腹膜外补片修补术(TEP)。结果：Ⅲ、Ⅳ组患者手术时间均长于Ⅰ、Ⅱ组(P0.01)，Ⅰ组手术时间长于Ⅱ组(P0.05)。Ⅰ、Ⅱ组患者术后6 h疼痛均强于Ⅳ组(P0.01和P0.05)。Ⅲ、Ⅳ组中各1例中转开腹手术。经腹腔镜手术恢复工作时间显著快于Ⅰ、Ⅱ组(P0.01)。结论：TEP和TAPP治疗腹股沟疝的效果相似，较开放式修补术后疼痛少，恢复快。