改良腹腔镜经腹膜前腹股沟斜疝修补术治疗成人男性腹股沟斜疝的临床疗效分析
Clinical Analysis of Effect the Modified Transabdominal Preperitoneal Prosthesis in the Treatment of Adult Male Patients with Inguinal Hernia

目的：探讨改良腹腔镜经腹膜前腹股沟斜疝修补术(Transabdominal Preperitoneal Prosthesis, TAPP)的临床疗效，为TAPP提供更简便的术式，以期在临床上推广。方法：分析2017年3月至2019年9月聊城大学第二附属医院东昌府人民医院200例成人男性单侧腹股沟斜疝手术患者的临床资料，按照术式不同分为两组，每组100例，分为改良TAPP组和TAPP组，分别分析两组患者的手术指标、复发情况及术式学习曲线等情况。结果：改良TAPP组手术时间、术中失血量和住院时间均少于TAPP组，差异具有统计学意义(P < 0.05)；改良TAPP组患者止痛药使用次数、疼痛评分及治疗费用均低于TAPP组，差异具有统计学意义(P < 0.05)；改良TAPP组腹壁下血管损伤、输精管损伤等副损伤总发生率低于TAPP组，差异具有统计学意义(P < 0.05)；改良TAPP术式学习曲线明显低于TAPP，差异具有统计学意义(P < 0.001)。结论：改良TAPP手术治疗腹股沟疝可以明显缩短手术时间以及减少副损伤发生率，效果良好且安全有效。
Objective: To explore the effect of the modified transabdominal preperitoneal prosthesis (TAPP), and to provide a more convenient surgical method for the TAPP, with a view to promoting it in clini-cal practice. Methods: The clinical data of 200 adult male patients with inguinal hernia admitted at the Second Affiliated Hospital of Liaocheng University and Dongchangfu People’s Hospital from March 2017 to September 2019 were analyzed, and they were divided into the modified TAPP group and the TAPP group according to the different operation method, with 100 cases in each group. The operation indicators, recurrence rate and the operation learning curve of the two groups were monitored respectively. Results: The operation time of the modified TAPP group was shorter than that of the TAPP group, the blood loss was less than that of the TAPP group, and the hospital stay was less than that of the TAPP group, the difference was statistically significant (P < 0.05). The frequency of analgesic use, pain score and treatment cost in the modified TAPP group were lower than that of the TAPP group, with statistically significant difference (P < 0.05). The incidence of subabdominal vascular injury, spermaduct injury and other side injuries in the modified TAPP group were lower than that of the TAPP group, with statistically significant difference (P < 0.05). The learning curve of the modified TAPP group was significantly lower than that of the TAPP group, with statistically significant difference (P < 0.001). Conclusion: The modified TAPP surgery for in-guinal hernia can significantly shorten the operation time and reduce the incidence of side injuries, with better effect and more security.