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使用不同方法固定网状内置假体的经腹腹膜前疝修补术(TAPP)与全腹膜外疝修补术(TEP)治疗腹股沟疝的比较评估

COMPARATIVE EVALUATION OF TAPP HERNIOPLASTY WITH USE OF VARIOUS METHODS OF FIXING THE RETICULAR ENDOPROSTHESIS AND TEP IN THE TREATMENT OF INGUINAL HERNIAS.

作者信息

Krikunov D, Akimov V, Toidze V, Churgulia M, Dvаladze L

机构信息

1 L.G. Sokolov Memorial Clinical Hospital № 122, Federal Medico-Biologic Agency, St. Petersburg; 2N.D. Monastyrsky Department of Surgery, North-Western State Medical University Named After I.I. Mechnikov, Ministry of Healthcare of Russian Federation, St. Petersburg, Ruassia.

出版信息

Georgian Med News. 2018 May(278):15-20.

PMID:29905538
Abstract

The study was conducted with the aim to improve the results of treatment of patients with inguinal hernia by the mode of glue fixation of mesh implant in laparoscopic hernioplasty. Laparoscopic hernioplasty was performed on 96 patients at the N.D. Monastyrsky Department of Surgery of North-Western State Medical University named after I.I. Mechnikov, on the base of L.G. Sokolov Clinical Hospital № 122, in the period from 2014 to 2016. The patients were divided into three groups: I group - 36 patients, who underwent laparoscopic transabdominal preperitoneal inguinal hernia repair (TAPP) without supplying of mesh implant under spermatic cord and its fixation with cyanoacrylate glue "B-Braun" with elimination of peritoneum defect above the implant with a thread V-loc; II group consisted of 34 patients, treated with laparoscopic TAPP without cutting of mesh implant and its fixation along the periphery with titanium staples with the subsequent closing of peritoneum defect with titanium staples. Group III included 26 patients who underwent total extraperitonеal laparoscopic hernioplasty without fixation of mesh implant. All patients were males. Complex analysis of the duration of surgical procedure, patients' quality of life, number of complications and level of abdominal pain in incipient post-operative period was carried out. Laparoscopic transabdominal preperitoneal inguinal hernia repair in combination with use of glue composition for fixation of mesh implant improves the quality of life of a patient during post-operative period, contributes to early discharge from the hospital and quicker recovery for resuming job activities.

摘要

本研究旨在通过腹腔镜疝修补术中使用胶水固定补片植入物的方式,改善腹股沟疝患者的治疗效果。2014年至2016年期间,在以伊·伊·梅契尼科夫命名的西北国立医科大学N.D. 莫纳斯蒂尔斯基外科教研室,以及L.G. 索科洛夫第122临床医院,对96例患者实施了腹腔镜疝修补术。患者被分为三组:第一组36例,接受腹腔镜经腹腹膜前腹股沟疝修补术(TAPP),精索下方不放置补片植入物,用“贝朗”氰基丙烯酸酯胶水固定,并使用V-loc缝线消除植入物上方的腹膜缺损;第二组34例,接受腹腔镜TAPP治疗,不裁剪补片植入物,沿周边用钛钉固定,随后用钛钉封闭腹膜缺损;第三组26例,接受完全腹膜外腹腔镜疝修补术,不固定补片植入物。所有患者均为男性。对手术时间、患者生活质量、并发症数量以及术后初期腹痛程度进行了综合分析。腹腔镜经腹腹膜前腹股沟疝修补术联合使用胶水组合物固定补片植入物,可改善患者术后生活质量,有助于早期出院并更快恢复工作活动。

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