单纯腹膜前修补与改良Kugel修补在腹股沟疝中的对比研究

目的比较经腹股沟切口前入路单纯腹膜前修补与改良Kugel修补术治疗原发性腹股沟疝,评价二种术式的疗效及优缺点。方法回顾性非随机对照方法,将2011年7月至2013年12月,上海交通大学医学院附属仁济医院嘉定分院收治的302例原发性腹股沟疝患者(其中17例为双侧)分为单纯腹膜前修补组(OP组)145例和改良Kugel修补组(MK组)157例。OP组采用Oval Patch补片修补,MK组采用Modified Kugel(MK)修补。比较二组患者在手术时间、住院时间、术后疼痛、手术并发症及复发率等方面的差异。结果二组患者的平均随访时间3～30个月,平均(12±5)个月。二组患者的平均手术时间、住院时间差异无统计学意义(t=0.164、0.939,P=0.870、0.349)。术后1周和1个月,OP组术后腹股沟区疼痛不适的发生率低于MK组,差异有统计学意义(χ2=4.704、2.297,P=0.030、0.021)。结论经腹股沟切口单纯腹膜前修补与改良Kugel修补术相比,单纯腹膜前疝修补术操作简单,可明显降低术后患者疼痛不适的发生率,具有较好临床应用价值。

Comparison of two tension-free repair techniques for inguinal hernias： preperitoneal inguinal hernioplasty and Modified Kugel repair

Objective To compare and evaluate the effect of preperitoneal inguinal hemioplasty and Modified Kugel repair for primary inguinal hernia. Methods A retrospective non-randomized controlled study was conducted, 302 patients （17 cases with bilateral hernias）admitted between July 2011 and December 2013 were allocated to preperitoneal inguinal hernioplasty group（ OP group, 145 cases） and Modified Kugel group （ MK group, 157 eases）. The operation time, hospital stay, postoperative pain, operative complications and recurrence rate were compared between two groups. Results The follow-up period ranged from 4 to 30 months （mean of 12 ＋ 5 months）. No significant differences were found between the two groups in the operation time and hospital stay （ t = 0. 164,0. 939, P = 0. 870,0. 349 ）, but the occurrence of postoperative groin pain at 1 week and 1 month was significantly lower in the OP group（X^2 =4. 704,2. 297,P = 0.030,0. 021 ）. Condusions Preperitoneal inguinal hemioplasty through an inguinal incision via the anterior approach is an effective tension- free procedure for inguinal hernia, resulting in less postoperative pain in the groin area.