中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (09) : 690 -693. doi: 10.3877/cma.j.issn.1674-0785.2020.09.005 × 扫一扫
所属专题： 文献；
临床研究
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Chong Wang1, Dandong Luo1, Rongrong Qu1, Guanqun Huang1,†()
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王翀, 罗丹东, 屈荣荣, 黄冠群. 腹腔镜经腹腹膜前疝修补术术中应用纱块钝性分离腹膜前间隙的效果分析[J]. 中华临床医师杂志(电子版), 2020, 14(09): 690-693.
Chong Wang, Dandong Luo, Rongrong Qu, Guanqun Huang. Efficacy of using gauze for blunt dissection of the preperitoneal space during laparoscopic transabdominal preperitoneal hernioplasty[J]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(09): 690-693.
探讨腹腔镜经腹腹膜前疝修补术（TAPP）术中应用纱块钝性分离腹膜前间隙的效果。
回顾性分析2017年1月至7月佛山市南海区人民医院行TAPP治疗的腹股沟疝136例。根据手术器械的不同将患者分为纱块游离组（36例）和直接游离组（100例）。采用t检验比较2组患者游离腹膜前间隙所花费的时间、出血量的差异，采用χ2检验比较2组患者术中腹膜破损发生率的差异。
136例患者术后通过门诊复诊及电话随访1年均未复发。纱块游离组患者平均手术时间短于直接游离组[（18.97±2.86）min vs（24.84±4.25）min]，出血量少于直接游离组[（6.29±2.82）ml vs（8.94±4.17）ml]，腹膜破裂发生率低于直接游离组[3.03%（3/36）vs 25.00%（25/100）]，2组比较差异均具有统计学意义（t=-9.181，P=0.027；t=-4.212，P=0.001；χ2=4.497，P=0.034）。
TAPP术中应用钳夹纱块钝性分离腹膜前间隙，可以缩短手术时间，减少术中出血量，术中腹膜破损的发生率也较低。
To evaluate the efficacy of using gauze for blunt dissection of the preperitoneal space during laparoscopic transabdominal preperitoneal hernioplasty (TAPP).
A retrospective analysis was performed on 136 patients with inguinal hernia who underwent TAPP at the Nanhai District People's Hospital from January to July 2017. The patients were divided into either a gauze dissection group (n=36) or a direct dissect group (n=100) according to the surgical instruments used. The time taken to dissect the preperitoneal space and the amount of blood loss were compared between the two groups by using t-test. The incidence of intraoperative peritoneal injury was compared between the two groups by chi-squared test.
No recurrence was found in 136 patients after surgery during the 1-year outpatient or telephone follow-up. The average operation time was significantly shorter [(18.97±2.86) min vs (24.84±4.25) min, t=-9.181, P=0.027], the amount of blood loss was significantly less [(6.29±2.82) ml vs (8.94±4.17) ml, t=-4.212, P=0.001], and the incidence of peritoneal rupture was significantly lower [3.03% (3/36) vs 25.00% (25/100), χ2=4.497, P=0.034] in the gauze dissection group than in the direct dissection group.
In TAPP, the application of gauze can effectively shorten the operation time, decrease the intraoperative blood loss, and reduce the incidence of intraoperative peritoneal damage.