临床外科杂志 ›› 2025, Vol. 33 ›› Issue (7): 753-.doi: 10.3969/j.issn.1005-6483.20240497

• 论著 • 上一篇    下一篇

腹腔镜下经腹腔腹膜前补片疝修补术与开放式无张力疝修补术治疗腹股沟疝的疗效及安全性比较

张少武 胡飞 张牙   

  1. 231600 合肥,安徽医科大学第一附属医院东城院区普外科一病区
  • 收稿日期:2024-04-07 出版日期:2025-08-20 发布日期:2025-08-20

Comparison of the efficacy and safety of laparoscopic transabdominal preperitoneal mesh hernia repair and tension-free hernia repair in the treatment of inguinal hernia

ZHANG Shaowu,HU Fei,ZHANG Ya.   

  1. Department of General Surgery No.1 Ward,Dongcheng Campus,the First Affiliated Hospital of Anhui Medical University,Anhui,Hefei 231600,China
  • Received:2024-04-07 Online:2025-08-20 Published:2025-08-20

摘要: 目的 对比腹腔镜下经腹腔腹膜前补片疝修补术(TAPP)与开放式无张力疝修补术(TFHR)治疗腹股沟疝的疗效及安全性。 方法 2021年1月~2023年6月收治的腹股沟疝病人85例,根据术式的不同分成两组:TAPP组42例,实施TAPP;TFHR组43例,实施开放式TFHR。比较两组手术指标、术后疼痛度情况、男性血清睾酮水平、术后并发症发生率及复发率。结果 TAPP组术中失血量、术后排气时间、住院时间少于TFHR组,两组比较差异有统计学意义(P<0.05);两组间术后数字疼痛强度量表(NRS)评分比较差异有统计学意义(P<0.05),各组内术后NRS评分均随时间推移逐渐降低,差异有统计学意义(P<0.05),组间和时间有交互作用,差异有统计学意义(P<0.05),其中TAPP组术后12小时、24小时、48小时均低于TFHR组,差异有统计学意义(P<0.05);术后1个月,两组血清睾酮水平和术前比较,差异无统计学意义(P>0.05),组间比较亦无差异(P>0.05);TAPP组术后并发症发生率(4.76%)低于TFHR组(18.60%),差异有统计学意义(P<0.05);两组术后6个月内均未见复发情况。结论 应用TAPP和开放式TFHR治疗的腹股沟疝的效果均较好,对睾丸功能均无影响。与开放式TFHR比较,TAPP术中失血量更少,术后疼痛度轻,并发症发生率更低,恢复时间更短。

关键词: 腹膜前补片疝修补术;无张力疝修补术;腹股沟疝;疼痛;并发症

Abstract: Objective To compare the efficacy and safety of laparoscopic transabdominal preperitoneal mesh hernia repair (TAPP) and tension-free hernia repair (TFHR) in the treatment of inguinal hernia.Methods From January 2021 to June 2023,85 patients with inguinal hernia were treated in our hospital.They were grouped into TAPP group (n=42,with TAPP) and TFHR group (n=43,with open TFHR) based on the different surgical procedures.The surgical indicators,postoperative pain,serum testosterone levels of male,incidence of postoperative complications,and recurrence rate were compared between two groups.Results Intraoperative blood loss,postoperative exhaust time,and hospital stay in the TAPP group were lower than those in the TFHR group (P<0.05);there was a difference in postoperative numerical rating scale (NRS) scores between two groups (P<0.05),postoperative NRS scores in each group gradually decreased over time (P<0.05),and there was an interaction among groups and time (P<0.05),among them,TAPP group had lower scores than TFHR group at 12,24,and 48 hours after surgery (P<0.05);one month after surgery,there were no difference in serum testosterone levels between the two groups compared before surgery(P>0.05),and there was no difference between the two groups(P>0.05);the incidence of postoperative complications in the TAPP group was lower than that in the TFHR group (4.76% vs 18.60%) (P<0.05);there was no recurrence within 6 months after surgery in both groups.Conclusion The application of TAPP and open TFHR in the treatment of inguinal hernia has good results,and there is no influence on testicular function.However,compared to open TFHR,TAPP has lower intraoperative blood loss,lower postoperative pain and complications,and shorter recovery time.

Key words: preperitoneal mesh hernia repair surgery;tension-free hernia repair surgery;inguinal hernia;pain;complications

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