Objective To retrospectively compare short-term outcomes and health economics of PHS versus UHS for inguinal hernia repair. Methods We included 105 patients suffering from reducible inguinal hernia hospitalized in the First Affiliated Hospital of Lanzhou University from September, 2007 and September, 2012. The referred hernia types involved direct and indirect hernia (unilateral and bilateral). Based on different repair materials, the patients were divided into two groups, PHS group (n=53) and UHS group (n=52). Outcome parameters for comparison included incidences of seroma and scrotum edema, hospital duration, costs, etc. Results There were no differences in age, sex, hernia type, incidences of seroma and scrotum edema after surgery, hospital duration and costs between the two groups. However, the patients in the PHS group spent less money than those in the UHS group regarding the costs of materials and hospitalization, with significant differences. Conclusion For inguinal hernia repair, PHS and UHS are alike in reducing short-term complications, but PHS can significantly reduce patients’ economic burden due to less costs.
目的 探讨采用卵圆钳分离建立腹膜外间隙的腹腔镜完全腹膜外疝修补术（TEP）的临床应用体会和经验。方法 笔者所在医院2007年8月至2011年7月期间在硬膜外麻醉下采用卵圆钳分离建立腹膜外间隙对117例患者行免钉合改良TEP。结果 117例患者中行TEP 114例，中转腹腔镜腹膜前疝修补术（TAPP）3例。手术时间38～196min，平均单侧58.6min，双侧106.5min。住院时间2～10d，平均4.2d。主要并发症为阴囊积液或血清肿11例（9.4％），阴囊积气8例 （6.8％），无其他并发症发生。随访时间12个月，无复发及腹股沟区慢性疼痛等远期并发症发生。结论 卵圆钳分离建立腹膜外间隙的TEP是安全可行和经济实用的。
目的 评价3DMax补片在腹腔镜下全腹膜外修补术(totally extraperitoneal,TEP)中修补腹股沟疝的价值。方法 回顾性分析我院2009年2～6月期间腹腔镜下应用3DMax补片对18例腹股沟疝患者行TEP的临床资料，分析其手术时间、住院时间、复发和并发症发生情况。结果 18 例患者中Ⅰ型疝3例，Ⅱ型疝4例，Ⅲ型疝9例，Ⅳ型疝2例； 斜疝11例，直疝6例，股疝1例。成功完成腹腔镜下TEP 17例。1例因疝内容物为末端回肠，与疝囊粘连并局部狭窄梗阻，中转开放手术切除部分回肠。手术时间40～95 min，平均65.4 min。术后均未使用镇痛剂，术后住院时间2～7 d，平均住院5.5 d。术后发生阴囊血清肿1例，经穿刺排液后愈合良好。随访1～6个月，无复发病例。结论 腹腔镜下TEP具有创伤小、恢复快、复发率低等优点，采用预先成型的3DMax 补片使手术操作更加简便。
Objective To evaluate the clinical experience and skills of laparoscopic totally extraperitoneal hernia repair with non-stapling of mesh and without using a balloon dissection in order to spread and popularize this kind of operation. Methods Under general anesthesia, 32 patients (42 sides) with inguinal hernias were repaired by laparoscopic totally extraperitoneal hernia repair with non-stapling of mesh and without using a dissection balloon from August 2005 to December 2007. Results All of operations were successfully performed. The operative time was 60-120 minutes, the blood loss was 20-60 ml, and the length of postoperative hospitalization was 3 days. All cases were followed up for 8 to 18 months and found no recurrence. Conclusion Laparoscopic totally extraperitoneal hernia repair with non-stapling of mesh and without using a balloon dissection is feasible, reliable and effective, offering a low recurrence rate, while its price is higher than tension-free herniorrhaphy by traditional method.
目的探讨普理灵疝装置（PHS）在腹股沟疝修补术中应用的技术要点和目前存在的问题。方法对218例使用普理灵疝装置行无张力修补术的腹股沟疝患者资料进行分析。结果218例患者手术顺利，平均手术时间54 min，术后平均住院时间2.5 d，并发症发生率5.5%（12/218），无复发病例。结论普理灵疝装置是无张力疝修补技术的重要内容，尤其适用于老年Ⅲ型疝和Ⅳ型疝。
Objective To explore the clinical efficacy of nursing measures based on the concept of enhanced recovery after surgery (ERAS) for patients undergoing day surgery of inguinal hernia repair. Methods A total of 120 patients scheduled for day surgery of inguinal hernia repair between January and June 2015 were randomized into ERAS group (n=60) and control group (n=60). Patients in the ERAS group received nursing optimized by the idea of ERAS during the perioperative period, while those in the control group received traditional routine nursing intervention. Postoperative visual analogue scale (VAS) scores, adverse responses, early ambulation, influence of pain on patients’ sleep, satisfaction of the patients and prolonged hospital stay rate were analyzed and compared between the two groups. Results VAS scores during hours 0-2, 2-4, 4-8, and 8-12 in the ERAS group were significantly lower than those in the control group (P < 0.05). Between hour 12 and 24, the VAS sco res were not significantly different between the two groups of patients (P > 0.05). Early postoperative ambulation, influence of pain on the sleep, and patients’ satisfaction on pain control and nursing care in the ERAS group were all significantly better than those in the control group (P <0.05). Conclusion Based on the concept of ERAS nursing intervention model, we can effectively reduce postoperative complications after inguinal hernia repair, accelerate patients’ postoperative rehabilitation, and increase patients’ satisfaction.
ObjectiveTo compare the efficiency of total extraperitoneal inguinal herniorrhaphy with laparoscopic technique using an innovative self-gripping mesh and polypropylene mesh. MethodsThe clinical data of 142 cases of unilateral inguinal hernia who underwent total extraperitoneal prosthesis (TEP) in our hospital form June 2012 to March 2015 were retrospectively analyzed. the operation type was total extraperitoneal inguinal herniorrhaphy with laparoscopic technique. Depending on the kind of mesh, all patients were divided into two groups from the self-gripping mesh group (n=60) and the polypropylene mesh group (n=82). ResultsThere was no significant difference in the operation time, intraoperative blood loss, hospital stay, and The Visual Analogue Score of post-operative (at 12, 24, 48, and 72 hours after operation) between the 2 groups (P>0.05). On the post-operative complications, there was no significant difference in incidences of total complication, scrotal edema, seroma, bladder injury, vascular injury of abdominal, and urinary reten-tion too (P>0.05). All the patients were followed up for 3-36 months (the median time was 19-month), and no recurrence occurred during the follow-up period. ConclusionInnovative self-gripping mesh is safe and effective, and maybe a good direction of mesh for material development.