Objective To study the efficiency of iaparoscopic inguinal hernia repair without the use of a mesh. Methods We used laparoscopic hernia repair without the use of a mesh in 92 cases of inguinal hernia. Results were compared with that of total extraperitoneal laparoscopic inguinal hernioplasty(TEP) in 91 cases from January 2001 to March 2004. Results The laparoscopic procedures were successfully performed in all the patients. In mesh-free and TEP group respectively the operating time was (21±4) min vs. (70±16) min (t=28. 01, P<0.05), hospital stay was (3.5±1.0) d vs. (4.8±1.2) d (t=7.96, P<0.05), average time off-bed was (1.0±0.5) d vs. (1.8±0.7) d (t=8.90, P<0.05), duration of pain was (1.0±0.5) d vs. (2.5±0.7) d (t=16.69, P<0.05), the expense was (4500±500) RMB yuan vs. (8000±820) RM B yuan(t=34.89, P<0.05), subcutaneous hematoma rate was 0% vs. 8.7% (χ~2=6.48, P<0.05). The 48 hour C-reaction protein level after the operation was (3.9±0.3) mg/dl and (8.8±0.5) mg/dl (t=80.48, P<0.05). All the difference was statistically significant between the two groups. All patients were followed up for 56.9±6.2 months. The recurrence rate was 0 and 2.1% (χ~2=0.51,P>0.05) respectively. Conclusions Mesh-free laparoseopie inguinal hernia repair is safe, cost-effective, as well as of much lower hernia recurrence.%目的 探讨免补片法腹腔镜下腹股沟疝修补的有效性.方法 回顾分析广东省第二人民医院2001年1月至2004年3月,应用腹腔镜免补片法治疗92例腹股沟疝的手术后恢复情况及随访结果,并与同期91例腹腔镜完全腹膜外疝修补手术(totally extraperitoneal laparoscopichemioplasty,TEP)的结果相比较.结果 免补片组与TEP组手术时间分别为(21±4)min与(70±16)min(t=28.01,P<0.05)、住院天数分别为(3.5±1.0)d与(4.8±1.2)d(t=7.96,P<0.05)、下床活动时间分别为(1.0±0.5)d与(1.8±0.7)d(t=8.90,P<0.05)、术后疼痛持续时间分别为(1.0±0.5)d与(2.5±0.7)d(t=16.69,P<0.05)、住院总费用分别为(4500±500)元与(8000±820)元(t=34.89,P<0.05),免补片组均明显优于TEP组,差异有统计学意义.免补片组无皮下血肿及阴囊水肿发生,TEP组皮下血肿8例(8.7%)(χ~2=6.48,P<0.05).免补片组与TEP组术后48h C-反应蛋白(CRP)分别为(3.9±0.3)mg/dl与(8.8±0.5)mg/dl(t=80.48,P<0.05).所有病例随访(56.9±6.2)个月,免补片组复发率为0,TEP组复发率为2.1%(χ~2=0.51,P>0.05).结论 腹腔镜免补片治疗腹股沟疝安全、可行,恢复快、住院时间短、费用少.
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