肝肾脏器移植术后腹股沟疝的2种手术方式效果分析
Effects of two surgical approaches for inguinal hernia after liver and kidney transplantation
牛磊 1刘烺飚 1武亚东 1蔡军1
作者信息
- 1. 首都医科大学附属北京友谊医院普通外科,北京,100050
- 折叠
摘要
目的 比较经腹腔腹膜前疝修补术(TAPP)和开放腹股沟疝无张力修补术(Lichtenstein式)对肝肾脏器移植术后腹股沟疝患者的疗效和安全性.方法 回顾性分析肝肾脏器移植术后腹股沟疝患者17例的临床资料.根据手术方式,将其中14例采用TAPP的患者设为试验1组,同时期无脏器移植手术史的20例患者作为对照1组;另外,3例采用Lichtenstein式的患者设为试验2组,同时期无脏器移植手术史的10例患者作为对照2组.统计分析手术时间、出血量、术后恢复情况,并分析不同脏器移植对手术方式选择的影响.结果 试验1组的手术时间为(50.17±14.52)min,对照1组为(33.77±10.19)min,差异有统计学意义(P＜0.05);2组出血量、术后下床时间和出院时间等方面比较,差异无统计学意义(P＞0.05).试验2组的手术时间为(41.87±12.55)min,对照2组为(27.14±10.64)min,出血量分别为(10.78±7.56)mL和(5.40±1.56)mL,差异有统计学意义(P＜0.05).试验1组和试验2组在手术出血量和出院时间方面比较,差异有统计学意义(P＜0.05).结论 TAPP可以提高患者的手术效果和安全性,减少并发症的发生,而对于肾移植合并输尿管移植术后腹股沟疝患者,Lichtenstein式较为安全.
Abstract
Objective To compare the efficacy and safety of transabdominal preperitoneal hernia repair(TAPP)and open tension-free inguinal hernia repair(Lichtenstein technique)for inguinal hernia after liver and kidney transplantation.Methods A retrospective analysis was conducted on data of 17 patients with inguinal hernia after liver and kidney transplantation.According to the surgi-cal methods,14 patients with TAPP were assigned to experimental group 1,and 20 patients without a history of organ transplantation during the same period were assigned to control group 1.Additionally,3 patients with the Lichtenstein technique were assigned to experimental group 2,and 10 patients without a history of organ transplantation during the same period were assigned to control group 2.Sta-tistical analysis was performed to compare operation time,blood loss,and postoperative recovery,and to analyze the impacts of different organ transplantation on surgical method selection.Results The operation time in experimental group 1 was(50.17±14.52)minutes,which was significantly longer than(33.77±10.19)minutes in the control group 1(P＜0.05).No significant differences were observed between the two groups in terms of blood loss,postoperative ambulation time,and hospital discharge time(P＞0.05).In experimental group 2,the operation time was(41.87±12.55)mi-nutes and the blood loss was(10.78±7.56)mL,which was significantly longer than(27.14±10.64)minutes and higher than(5.40±1.56)mL in control group 2(P＜0.05).There were sig-nificant differences in surgical blood loss and hospital discharge time between experimental group 1 and experimental group 2(P＜0.05).Conclusion TAPP can improve surgical outcomes and safety,and reduce occurrence of complications.For patients with inguinal hernia after kidney transplantation combined with ureteral transplantation,the Lichtenstein technique is safer.
关键词
腹股沟疝/腹腔镜/修补术/肝移植/肾移植Key words
inguinal hernia/laparoscopy/hernia repair/liver transplantation/kidney trans-plantation引用本文复制引用
基金项目
北京市属医院临床医学发展专项基金(XM-LX201703)
出版年
2024
国家科技期刊平台
NSTL
万方数据