The Comparison on the Selfgripping Patch with Different Pavement Methods in Bilateral Laparoscopic Herniorrhaphy for Inguinal Hernia
DU Yi-hong1, LIU Yun-li2, LIU Ming-jie1
1.Department of General Surgery, Chang'an Hospital, Xi'an 710016, Shaanxi, China； 2.Department of Prevention and Healthcare, Traditional Chinese Hospital of Fufeng, Fufeng 722200, Shaanxi, China
摘要 目的探讨不同修补材料和铺置方法对腹腔镜双侧腹股沟疝修补术疗效的影响。
方法选取2013年9月～2016年1月期间我院确诊并行腹腔镜双侧腹股沟疝修补术患者180例，依据术中固定补片类型分为：聚丙烯组60例，采用常规聚丙烯补片修补；自固定组120例，予自固定补片修补，根据据铺置方法又分为改良组（n=60例）和常规组（n=60例），分别采用改良和常规方法铺置补片。采用视觉模拟评分法（VAS）评估疼痛程度，自制《腹腔镜双侧腹股沟疝修补术患者满意度问卷》评估患者满意度。随访12个月，记录并比较所有患者手术指标（铺片、手术、住院时间、术中出血量、住院费用）、术后并发症、疼痛及满意度。结果改良组和常规组患者铺片时间、手术时间、住院时间、术中出血量、住院费用以及术后1、7、15 d VAS评分均明显低于聚丙烯组，术后6个月和12个月患者满意率明显高于聚丙烯组，差异均有统计学意义（P<0.05）。改良组患者铺片时间、手术时间、术中出血量明显低于常规组，差异均有统计学意义（P<0.05）；而两组患者住院时间、费用、术后各期VAS评分、术后并发症率和患者满意率比较，差异均无统计学意义（P>0.05）。三组患者均无复发。结论腹腔镜双侧腹股沟疝修补术中应用自固定补片可有效缩短中操作时间，减小创伤，减轻术后疼痛，促进患者恢复，降低治疗费用，有利于提高患者满意度，且并不增加并发症和复发风险；术中通过改良补片铺置方法可进一步使补片展开更加快捷并减少患者术中创伤，值得临床推广。
Abstract: ObjectiveTo discuss the effect of different patches and pavement methods in bilateral laparoscopic herniorrhaphy for inguinal hernia.MethodsThe clinical data of 180 cases with inguinal hernia performed bilateral laparoscopic herniorrhaphy inguinal from September 2013 to January 2016 in our hospital were analyzed retrospectively. According to fixed patch type, all cases were dived into two groups: The polypropylene group (n=60) was repaired by conventional polypropylene patch, and the selffixed group (n=120) was repaired by selfgripping patch. According to the pavement methods, the latter was divided into the improved group and the conventional group with 60 cases for each, and was carried out improved and regular pavement method during the surgery respectively. The visual analogue scale (VAS) was used to assess the degree of pain, and the satisfaction questionnaire of bilateral laparoscopic inguinal herniorrhaphy was used to assess the satisfaction of the patients. All cases were followed up for 12 months. The operative indexes as pavement time, operation time, hospital stays, intraoperative blood loss, hospitalization cost and postoperative complication rate, VAS score and satisfaction rate were recorded and compared.ResultsThe pavement, surgery, hospitalization time, intraoperative blood loss, hospitalization cost, and VAS score of 1, 7, 15 d after the surgery were significantly lower, and the satisfaction rate was obviously higher in the selffixed group (including both improved group and conventional group) than those in the polypropylene group, and all the differences were statistically (P<0.05). The pavement time, operative time and intraoperative blood loss of the improved group was remarkable lower in those of the conventional group (P<0.05), but there was no statistical difference in hospital stays, cost, VAS score of different time point after the surgery, postoperative complication rate and satisfaction rate between two groups (P>0.05). No recurrence was found in all cases.ConclusionsThe application of selffixed patch can effectively shorten the operating time, decrease the trauma and postoperative pain, and then promote the patient's recovery, reduce the treatment costs, increase the patient's satisfaction rate for bilateral laparoscopic inguinal hernia repair without increasing the risk of complication and recurrence. During the surgery, the improved patch pavement method can unfold the patch quickly and expediently, and is worthy of popularization.
杜一鸿1， 刘云莉2， 刘明杰1. 自固定补片不同铺置方法在腹腔镜双侧腹股沟疝修补术中的应用[J]. 中国现代手术学杂志, 2017, 21(5): 344-349.
DU Yi-hong1, LIU Yun-li2, LIU Ming-jie1. The Comparison on the Selfgripping Patch with Different Pavement Methods in Bilateral Laparoscopic Herniorrhaphy for Inguinal Hernia. Chinese Journal of Modern Operative Surgery, 2017, 21(5): 344-349.
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2017, Vol. 21 
