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find Keyword "经腹膜前" 2 results
  • 腹腔镜TAPP治疗腹股沟嵌顿疝的临床分析

    目的探讨腹腔镜经腹膜前补片修补术(TAPP)治疗腹股沟嵌顿疝的安全性及优势。 方法2012年3月至2015年3月期间我院共治疗腹股沟嵌顿疝患者25例,全麻后,先在腹腔镜下还纳疝内容物,若肠管未坏死,则行TAPP术。 结果25例手术患者中,3例合并肠坏死,于腹腔镜下完成肠切除或肠造口术;22例患者成功施行TAPP手术,未中转开腹,术后无补片感染及严重并发症发生。随访1~4年,未见复发。 结论TAPP治疗腹股沟嵌顿疝探查便利,操作方便,安全可行,疗效可靠,优势明显。

    Release date:2016-10-02 04:54 Export PDF Favorites Scan
  • Risk prediction model for chronic pain after laparoscopic preperitoneal inguinal hernia repair

    Objective To explore the risk factors of chronic postoperative inguinal pain (CPIP) after transabdominal preperitoneal hernia repair (TAPP), establish and verify the risk prediction model, and then evaluate the prediction effectiveness of the model. Methods The clinical data of 362 patients who received TAPP surgery was retrospectively analyzed and divided into model group (n=300) and validation group (n=62). The risk factors of CPIP in the model group were screened by univariate analysis and multivariate logistic regression analysis, and the risk prediction model was established and tested. Results The incidence of CPIP at 6 months after operation was 27.9% (101/362). Univariate analysis showed that gender (χ2= 12.055, P=0.001), age (t=–4.566, P<0.01), preoperative pain (χ2=44.686, P<0.01) and early pain at 1 week after operation (χ2=150.795, P<0.01) were related to CPIP. Multivariate logistic regression analysis showed that gender, age, preoperative pain, early pain at 1 week after operation, and history of lower abdominal surgery were independent risk predictors of CPIP. The area under curve (AUC) of the receiver operating characteristic (ROC) of the risk prediction model was calculated to be 0.933 [95%CI (0.898, 0.967)], and the optimal cut-off value was 0.129, while corresponding specificity and sensitivity were 87.6% and 91.5% respectively. The prediction accuracy, specificity and sensitivity of the model were 91.9% (57/62), 90.7% and 94.7%, respectively when the validation group data were substituted into the prediction model. Conclusion Female, age≤64 years old, preoperative pain, early pain at 1 week after operation and without history of lower abdominal surgery are independent risk factors for the incidence of CPIP after TAPP, and the risk prediction model established on this basis has good predictive efficacy, which can further guide the clinical practice.

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