目的 比较经腹腔腹膜前腹股沟疝修补术(transabdominal preperitoneal,TAPP)、完全腹膜外腹股沟疝修补术(totally extraperitoneal,TEP)和常规腹股沟疝修补术的优缺点,探讨应用于武警官兵的术式选择。方法 回顾性分析2012-01至2018-01医院治疗武警官兵腹股沟疝的临床资料,总结手术疗效、并发症及术后恢复效果。结果 128例均成功完成手术。TAPP组手术时间明显长于常规手术组及TEP组(P<0.05)。常规手术组术后住院时间明显长于TAPP组及TEP组(P<0.05)。常规手术组第2天VAS评分明显高于TAPP、TEP组(P<0.05)。术后1个月,常规手术组在IPQ评分0分、参加日常训练及固定执勤任务、参加3 km越野跑的比例明显低于TAPP、TEP组(P<0.05)。术后3个月,常规手术组参加3 km越野跑的比例仍明显低于TAPP组、TEP组(P<0.05)。结论 腹腔镜下腹股沟疝修补手术具有微创、疼痛轻、恢复快、并发症少等优点,武警官兵能较早恢复日常训练及执勤任务,特别是TEP术式更值得部队医院推广。

Objective To compare the advantages and disadvantages of transabdominal preperitoneal (TAPP), totally extraperitoneal (TEP) and conventional inguinal herniorrhaphy, and to explore the selection of surgica Methods for military inpatients.Methods The clinical data of cases of inguinal hernia treated in our hospital from January 2012 to January 2018 was analyzed retrospectively, and the operative effect, complications and postoperative recovery were summarized.Results Operations on 128 cases were successful. The duration of surgery in TAPP group was significantly longer than that in conventional operation group and TEP group (P<0.05). The postoperative length of hospital stay in the conventional operation group was longer than that in TAPP group and TEP group (P<0.05). The VAS score of conventional operation group was significantly higher than that of TAPP group and TEP group on the second day (P<0.05). One month after operation, the number of cases with an IPQ score of 0 and involved in daily training, fixed duty and 3-kilometer cross-country running in the conventional operation group was significantly smaller than that in TAPP group and TEP group(P<0.05). At 3 months after operation, the number of cross-country runners in the conventional operation group was significantly smaller than that in TAPP group and TEP group (P<0.05).Conclusions Laparoscopic inguinal hernia repair has the advantages of minimal invasion, mild pain, quick recovery and fewer complications. Military inpatients can resume their daily training and duty earlier. TEP operations are worth popularizing in military hospitals.