腹腔镜全腹膜外补片与改良Kugel补片疝修补比较

目的：比较腹腔镜全腹膜外不钉合补片植入术与改良Kugel补片用于腹股沟疝修补术的临床疗效。方法：从2005年1月至2008年10月对腹股沟患者采用腹腔镜全腹膜外不钉合补片植入术（TEP组,45例）或改良Kugel补片植入术（Kugel组,64例）,分析比较手术时间、术中出血量、切口情况、复发率等术中、术后相关指标。结果：两组一般情况差异没有统计学差异,TEP组手术时间长于Kugel组（P〈0.05）,切口情况好于Kugel组（P〈0.05）,术中出血量、尿潴留、术后疼痛、住院天数均少于Kugel组（P〈0.05）。但两组随访1年的复发率没有统计学差异（P〉0.05）。结论：腔镜全腹膜外不钉合补片植入术较改良Kugel补片植入术更具微创手术的特点;改良Kugel手术应用范围更广,临床上两种术式具有互补性。

Comparing Therapeutic Effect of Laparoscopic Totally Extraperitoneal and Modified Kugel Hernia Patch Herniorrhaphy on Inguinal Hernia

Objective： To compare the effect of non-stapling totally extraperitoneal and modified Kugel hernia patch herniorrhaphy on patients with inguinal hernia.Method： Patients with inguinal hernia from January 2005 to October 2008 were performed either non-stapling totally extraperitoneal（TEP group,45 cases）or modified Kugel hernia patch herniorrhaphy（Kugel group,64 cases）.Some relative intra-operative and postoperative items were compared between two groups.Result： There’s no significant differences（P〉0.05） in for the patients’ general situations.Duration of surgery of TEP group was longer than that of Kugel group.However the complications of the incisal opening,intra-operative blood loss,length of stay,postoperative pain were less than those in Kugel group.There were no statistical difference between two groups.Conclusion： Non-stapling totally extraperitoneal herniorrhaphy is less vulnerarious than modified Kugel hernia patch herniorrhaphy,but the application of Kugel is more extensive.