彭晓飞 陈翔 温伟忠

[摘要]目的 探討腹腹腔镜经腹腔腹膜前疝修补术（TAPP）治疗腹股沟疝的效果。方法 选取我院2016年1月～2017年10月收治的100例腹股沟疝患者作为研究对象，根据手术方法不同进行分组。对照组（20例）采用传统术式，TAPP组（40例）实施TAPP手术，TEP组（40例）实施TEP手术。比较三组的手术时间、术后自主活动时间、术后留院观察时间、术后创口处疼痛程度、手术出血量情况及阴囊水肿、感染、尿潴留的总发生率。结果 TAPP组及TEP组的手术时间、术后自主活动时间、术后留院观察时间、术后创口处疼痛程度、手术出血量情况比较，差异无统计学意义（P>0.05）；TAPP组及TEP组阴囊水肿、感染、尿潴留的总发生率比较，差异无统计学意义（P>0.05）。上述指标中，TAPP组及TEP组均优于对照组，差异有统计学意义（P<0.05）。结论 TAPP在临床中的应用效果确切，手术操作时间较短，创伤较开放术较小，可减少出血和并发症，加速术后康复进程，而和TEP手术对比效果相似。

[关键词]腹腔镜经腹腔腹膜前疝修补术；临床应用效果；腹股沟疝

[中图分类号] R656.21 [文献标识码] A [文章编号] 1674-4721（2018）5（b）-0035-03

Effect of laparoscopic transabdominal preperitoneal prosthetic on inguinal hernia

PENG Xiao-fei CHEN Xiang WEN Wei-zhong

Department of Gastrointestinal Surgery，the Sixth Affiliated Hospital of Guangzhou Medical University Qingyuan People′s Hospital，Guangdong Province，Qingyuan 511518，China

[Abstract]Objective To investigate the effect of laparoscopic transabdominal preperitoneal prosthetic （TAPP） on inguinal hernia.Methods From January 2016 to October 2017，100 patients with inguinal hernia treated in our hospital were selected as the subjects，and grouped according to different surgical methods.The control group （20 cases） were treated with traditional operation.TAPP group were treated with TAPP surgery，and TEP group were treated with TEP surgery.The operative time，postoperative autonomic activity time，postoperative observation time，postoperative pain at the wound site，intraoperative amount of bleeding，and the total incidence of scrotal edema，infection，and urinary retention were compared among the three groups.Results There was no significant difference in the operation time，postoperative autonomic activity time，postoperative observation time，postoperative pain at the wound site，or intraoperative amount of bleeding between TAPP and TEP groups （P>0.05）.The total incidence of scrotal edema，infection，and urinary retention were not displayed significant difference in the TAPP and TEP groups （P>0.05）.However，the above indicators in the TAPP and TEP groups were all better than those in the control group，the difference was statistically significant （P<0.05）.Conclusion The clinical application of laparoscopic TAPP obtains a definite effect at advantages of shorter operation time，smaller trauma compared with open surgery，reduce intraoperative bleeding and complications after surgery，and promote the postoperative recovery，which is tantamount to TEP surgery in efficacy.

[Key words]Laparoscopic transabdominal preperitoneal prosthetic；Clinical application effect；Inguinal hernia

腹股沟疝是普外科的常见多发病，在腹外疝中占90%以上。目前治疗腹股沟疝多采用无张力疝修补术，但术后康复时间长，并发症和复发率较高。随着微创技术的不断发展，腹腔镜经腹腔腹膜前疝修补术（TAPP）在腹股沟疝治疗中应用越来越广泛，其具有美观、微创、疼痛轻和切口小等特点，但手术要求也相应较高[1-2]。腹腔镜全腹膜外疝修补术（TEP）本质是利用腹腔镜器械，通过后入路在直视下操作进行的一种腹膜前修补手术，其特点是不进入腹腔，直接进入腹膜前间隙进行操作，也具有微创性，和TAPP比较在入路方面有所不同。本研……