摘要目的 评估腹腔镜完全腹膜外疝修补术(totally extraperitoneal hernia repair,TEP)免钉合、双网片交叠术式的安全性、可靠性,并探讨主要并发症的原因.方法 243腹股沟疝例患者按入院日期的单双号分组,单号为单网片钉合固定组136例,双号为免钉合、双网片交叠组107例,均行TEP修补手术.对手术结果进行t检验或χ2检验.结果 本组243例,随访233例,随访率96%.平均随访(28±6)个月,免钉合、双网片交叠组的复发率(1.9%)与钉合固定组(2.9%)比并无增加(P＞0.05);两组间总并发症以及慢性神经痛、感觉异常、阴囊血肿、血清肿、术区感染、睾丸鞘膜积液、大出血、肺炎、尿路感染等各并发症均差异无统计学意义(均P＞0.05).结论 腹腔镜完全腹膜外疝修补术免钉合、双网片交叠术式没有增加术后复发率,安全、可靠,可减少因钉合固定所致并发症的发生.

abstractsObjective To assess the safety and effectiveness of laparoscopically total extraperitoneal (TEP) repair using two mesh cross and overlap without stapler technique and to discuss the cause of main complications. Methods In this study 243 cases of inguinal hernia were randomly divided into two groups. One group underwent two meshes cross and overlap no fixation TEP, the other underwent a single mesh stapling fixation TEP. The average postoperative follow-up was ( 28 ± 6 ) months. For comparing the effect of the two approaches, statistical analysis including the χ2 test and Student's t test was carried out where appropriate. A p value of less than 0. 05 was considered statistically significant. Results The recurrence rate for the mesh no fixation group ( 1.9% ) did not increase when compared to mesh fixation group( 2. 9% ) ( P ＞ 0. 05 ). The overall postoperative complication rate or individual complication rate was not significantly different between the two groups. Conclusions Laparoscopically total extraperitonealrepair(TEP) using two mesh cross and overlap no fixation technique is safe and reliable.