目的 比较腹腔镜下经腹腹膜前腹股沟疝修补术(transabdominal preperito-neal,TAPP)与无张力腹股沟疝修补术治疗腹股沟疝的临床效果。方法 选取2021-01至2024-09武警安徽总队医院普通外科收治的腹股沟疝患者53例,依据手术方式分为观察组(25例,实施TAPP)与对照组(28例,实施无张力腹股沟疝修补术)。对比两组一般情况、并发症、对侧疝再发情况及术后恢复情况。结果 两组年龄、疝的位置、手术时间比较,差异无统计学意义。观察组术中出血量(5.60±2.78)ml,低于对照组的(10.36±3.83)ml,差异有统计学意义(P＜0.05);观察组住院时间(10.38±1.33)d,短于对照组的(13.56±2.94)d,差异有统计学意义(P＜0.05);观察组首次下床时间(18.23±3.90)h,短于对照组的(22.17±4.72)h,差异有统计学意义(P＜0.05);观察组术后6 h VAS评分(3.85±0.80)分,低于对照组的(4.72±0.57)分,差异有统计学意义(P＜0.05);观察组术后12、24、72 h VAS评分与对照组比较,差异无统计学意义。观察组并发症发生率低于对照组(4% vs. 25%),差异有统计学意义(P＜0.05)。观察组对侧疝再发率高于对照组,但差异无统计学意义。观察组术后1、3、6个月局部异物感发生率均低于对照组(8% vs. 39.29%,0% vs. 17.86%,0% vs. 3.57%),其中两组术后1个月、3个月比较,差异有统计学意义(P＜0.05);观察组术后1个月、3个月无法耐受轻体力活动发生率均低于对照组(8% vs. 32.14%,4% vs. 10.17%),其中术后1个月两组比较,差异有统计学意义(P＜0.05),两组术后6个月均能耐受轻体力活动;两组术后1个月均未进行重体力活动,观察组术后3个月、6个月无法耐受重体力活动发生率均低于对照组(4% vs. 21.43%,0 vs. 7.14%),但差异无统计学意义。结论 无张力腹股沟疝修补术、TAPP在腹股沟疝治疗中均具有良好疗效,但TAPP对患者损伤小,出血量少,疼痛轻微,并发症少,且恢复更快。

Objective To compare the clinical effects of transabdominal preperitoneal(TAPP) laparoscopic inguinal hernia repair and tension-free inguinal hernia repair in the treatment of inguinal hernia. Methods A total of 53 patients with inguinal hernia admitted to Anhui Provincial Corps Hospital of Chinese People’s Armed Police Force from January 2021 to September 2024 were enrolled and divided into an observation group (25 cases, undergoing TAPP) and a control group (28 cases, undergoing tension-free inguinal hernia repair). General conditions, complications, recurrence of contralateral hernia, and postoperative recovery of the two groups were compared. Results There were no statistically significant differences in age, hernia location, or operation time between the two groups. However, the observation group experienced significantly less intraoperative blood loss[(5.60±2.78) ml vs. (10.36±3.83) ml, P＜0.05], shorter hospital stay (10.38±1.33)d vs. (13.56±2.94)d, P＜0.05), and earlier postoperative ambulation [(18.23±3.90)h vs. (22.17±4.72) h,P＜0.05]. The visual analogue scale(VAS) score of 6 hours postoperatively was significantly lower in the observation group (3.85±0.80) than in the control group (4.72±0.57),P＜0.05. VAS scores of 12, 24, and 72 hours postoperatively were not significantly different between the groups. The incidence of postoperative complications was significantly lower in the observation group compared to the control group (4% vs. 25%), and the difference was statistically significant (P＜0.05). The observation group had a higher recurrence rate of contralateral hernia, , but the difference was not statistically significant . The incidence of local foreign body sensation at 1 month and 3 months postoperatively was significantly lower in the observation group (8% vs. 39.29% at 1 month; 0% vs. 17.86% at 3 months, P＜0.05 for both). By 6 months, the difference was not statistically significant. The incidence of inability to tolerate light physical activity at 1 month and 3 months after surgery was lower than that in the control group (8% vs. 32.14%, 4% vs. 10.17%), and the differences were statistically significant (P<0.05). The incidence of inability to tolerate heavy physical activity in the observation group at 1 month and 3 months after surgery was lower than that in the control group (4% vs. 21.43%, 0 vs. 7.14%), but the differences were not statistically significant. At 6 months after surgery, both groups were able to tolerate light physical activity; the observation group had no heavy physical activity at 1 month after surgery, and the incidence of inability to tolerate heavy physical activity at 3 and 6 months after surgery was lower than that in the control group (4% vs. 21.43%, 0 vs. 7.14%), but the differences were not statistically significant. Conclusions Tension-free inguinal hernia repair and TAPP repair both demonstrate good therapeutic effects in the treatment of inguinal hernia. However, TAPP causes less damage, less blood loss, less pain, fewer complications, and a more rapid recovery.