1. 纵向与横向腹膜切开法在老年腹股沟疝 TAPP 中应用效果研究.
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赵肖累, 谭 磊, and 王晓波
- Abstract
Objective To explore the application effect of longitudinal and transverse peritoneal incision methods in elderly patients with inguinal hernia undergoing transabdominal preperitoneal prosthesis (TAPP). Methods A total of 84 elderly patients with inguinal hernia who underwent TAPP surgery from May 2021 to March 2023 at this hospital were selected. They were divided into two groups based on different peritoneal incision methods performed during surgery. The control group comprised 42 patients who underwent transverse peritoneal incision, while the study group comprised 42 patients who underwent longitudinal peritoneal incision. Surgical indicators, stress response indicators [norepinephrine (NE), cortisol (Cor), aldosterone (ALD), epinephrine (E)], postoperative pain levels, quality of life, and incidence of complications were observed and compared between the two groups. Results The study group had less intraoperative blood loss, shorter operative time, shorter duration of mesh implantation, earlier time to first ambulation, and shorter hospital stay compared to the control group, and the differences were statistically significant (P <0. 05). Compared with those before operation, postoperative levels of NE, E, ALD, and Cor increased in both groups, but the levels in the study group were lower than those in the control group, and the differences were statistically significant (P <0. 05). The visual analogue scale (VAS) scores at different time points postoperatively, analyzed using repeated measures ANOVA, showed significant differences between groups (Fgroups=115. 291, P < 0. 001), over time (Ftime=52. 438, P <0. 001), and in the interaction between time and groups (Ftime×groups = 619. 351, P <0. 001). Further individual comparisons revealed that VAS scores at 6, 12, and 24 hours postoperatively were lower in the study group compared to the control group, with statistically significant differences (P <0. 05). The SF-36 scores for all items increased postoperatively compared to preoperative levels in both groups, with higher scores in the study group than in the control group, and the differences were statistically significant (P <0. 05). During treatment and follow-up, there was no statistically significant difference in the incidence of complications between the two groups (16. 67% vs. 4. 76%; P >0. 05). Conclusion Both transverse and longitudinal peritoneal incision methods in TAPP are effective for treating elderly patients with inguinal hernia, but the longitudinal peritoneal incision method is more effective. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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