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岭南现代临床外科 ›› 2018, Vol. 18 ›› Issue (05): 524-527.DOI: 10.3969/j.issn.1009-976X.2018.05.007

• 论著与临床研究 • 上一篇    下一篇

Gilbert术式与Lichtenstein、Rutkow术式在治疗Ⅲ型腹股沟疝中的比较

陈文锋,郑喜岳,黄鹏   

  1. 汕头市澄海区人民医院
  • 通讯作者: 陈文锋

Comparison between three different procedures of Gilbert,Lichtenstein and Rutkow and in the treatment of inguinal hernia

CHEN Wenfeng,ZHENG Xiyue,HUANG Peng   

  1. Department of General Surgery,Chenghai People′s Hospital of Shantou,Shantou,Guangdong 515800, China
  • Online:2018-10-20 Published:2018-10-20

摘要: [摘要]目的 比较Gilbert术式与Lichtenstein、Rutkow术式应用于巨大腹股沟疝中的效果。方法 选择2012年1月~2016年12月在我院治疗的巨大腹股沟疝患者,将入选的168例患者根据手术方法不同分成三组,Lichtenstein术组(65例),Rutkow术组(53例)和Gilbert术组(50例)。3组患者观察、记录和统计参数包括手术时间、术后疼痛、股静脉血流速度、早期和晚期并发症、复发率、住院时间和住院费用。结果 各组间在年龄、性别、疝类型和分类、术后疼痛和晚期并发症方面无差异(P>0.05)。手术时间Lichtenstein组为62.2±22.7min,Rutkow组为57.4±19.8min,Gilbert组为75.4±34.3min,三组间差异具有统计学意义(所有P<0.05)。Lichtenstein组、Rutkow组和Gilbert术组平均股静脉血流速度术前值分别为14.08±4.27cm/s、12.99±3.91cm/s和14.32±3.25cm/s,三组间对比没有统计学差异(P=0.173);术后平均股静脉血流速度分别为13.01±2.32cm/s、12.02±2.07cm/s和13.93±2.77cm/s,三组对比有统计学差异(P=0.016)。早期并发症中,在Lichtenstein组中3例(4.61%)、Rutkow组1例(1.87%)和Gilbert组4例(6%)观察到血肿。Lich?tenstein、Rutkow和Gilbert组手术费用分别为12887±595、13573±647和14201±875,三组之间有统计学差异(P<0.05)。结论 三种手术有各自特点,Gilbert术式效果更好,但操作稍复杂,需时较长;Lichtenstein术式较简单,若选择局麻下操作可行。

关键词: Rutkow 手术, 腹股沟疝, Lichtenstein 手术, Gilbert 手术

Abstract: [Abstract] Objective To compare the outcomes of three different tension- free repair approaches known as Lichtenstein, Rutkow and Gilbert. Methods 168 patients with type III inguinal hernia were assigned to three groups, Lichtenstein group(n=65), Rutkow group(n=53)and Gilbert group(n=50). The comparisons across groups were carried out in terms of operation length, postoperative pain, femoral vein flow velocity, complications, recurrence, length of hospital stay, and cost. Results No difference was found among the groups regarding age, gender, postoperative pain, and late complications (all P values >0.05). There was a statistical difference in operation length in three groups(P<0.05). The preoperative values of mean femoral venous flow velocity in the Lichtenstein, Rutkow, and Gilbert groups were 14.08±4.27 cm/s, 12.99±3.91 cm/s, and 14.32±3.25 cm/s, respectively(P=0.173), While postoperative values were 13.01±2.32 cm/s, 12.02±2.07 cm/s, and 13.87±4.57 cm/s, respectively(P=0.016). However, no difference was determined between the groups regarding the decrease rates. Among early complications, hematoma was observed in three (4.6%) patient of Lichtenstein group, five (9.4%) patients of Rutkow group, and 5(10%)patients of Gilbert group(P=0.033). Cost for Lichtenstein, Rutkow, and Gilbert groups was RMB 12887±595, 13573±647, and 14201±875, respectively(P<0.001). Conclusion The three kinds of surgery have their own characteristics, Gilbert′s operation had better effects, however, the operation is slightly more complicated;Lichtenstein′s operation is simpler, it is feasible whenthe operation performed under local anesthesia.

Key words: Rutkow, comparison, Lichtenstein, Gilbert, inguinal hernia

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