中国实用外科杂志

中国实用外科杂志 ›› 2005, Vol. 25 ›› Issue (10): 1-613.

• 专题笔谈 •    下一篇

腹腔镜完全腹膜外与经腹腹膜前疝修补术临床对照分析

臧潞 李健文 毛志海 陆爱国 王明亮 董峰 马君俊 冯波 胡艳艳 郑民华   

  1. 上海交通大学医学院附属瑞金医院普外科 上海市微创外科临床医学中心(200025)
  • 收稿日期:2005-04-20 修回日期:2005-06-22 出版日期:2005-10-20 发布日期:2005-10-20

  • Received:2005-04-20 Revised:2005-06-22 Online:2005-10-20 Published:2005-10-20

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摘要：

目的 比较腹腔镜完全腹膜外疝修补术（TEP）和腹腔镜经腹腹膜前疝修补术（TAPP）治疗腹股沟疝的安全性和有效性。方法 回顾性分析2003年1月至2004年6月TEP 30例（36例次）以及同期TAPP 61例（64例次）临床资料。比较两组平均手术时间、术后平均住院时间、术后并发症、术后复发以及治疗费用。结果 平均手术时间和术后住院时间TEP组分别为（5833±1360）min和（523±185）d，TAPP组为（6328±2004）min和（587±152）d，两者差异无显著性（P>005）。〖JP2〗术后并发症TEP组5例，TAPP组13例，两组差异无显著性（〖WTBX〗P>〖WTBZ〗005）。术后平均随访时间TEP组13（3~21）个月，TAPP组为14（4~23）个月；TEP组无复发病例，TAPP组有2例复发。平均手术费用TEP组为（6 35932±59686）元，TAPP组为（8 29818±71383）元，两者差异有显著性（〖WTBX〗P<〖WTBZ〗001）。〖JP〗结论 TEP与TAPP治疗腹股沟疝均安全有效；TEP相对TAPP手术费用更低，临床推广更具优势。

Abstract:

Abstract Objective To compare the safety and efficiency of totally extraperitoneal technique (TEP) and transabdominal preperitoneal technique (TAPP) for inguinal hernia. Methods The mean operation time,the postoperative hospital stay,the operation cost,the complications and the recurrence of 30 patients (36 procedures) undergoing TEP and 61 patients (64 procedures) undergoing TAPP in minimally invasive surgery center of Ruijin Hospital were retrospectively evaluated. Results The mean operation time and postoperative hospital stay of TEP group was (5833±1360)min and (523±185) d respectively,which was comparable with those of the TAPP group (6328±2004)min and (587±152)d respectively.The cases of TEP were followedup for 3~21 months with a median of 13,while the followup time of TAPP were 4~23 months with a median of 14.〖JP2〗Two recurrences occurred in TAPP group while none in TEP group.There were no difference of complications between TEP and TAPP group.The operation cost of TEP group was significantly lower than that of TAPP group:(6 35932±59686)RMB vs (8 29818±71383)RMB,(P<001). Conclusion TEP and TAPP are both safe and efficient for inguinal hernia and TEP might be adopted widely for its economical advantage.