Abstract:

Objective　To systematically evaluate the clinical efficacies of laparoscopic and traditional open surgery for patients with abdominal external hernia, and to provide support for seeking better treatment methods and evidence-based medicine. Methods　The authors comprehensively searched the literatures on external abdominal hernia published at home and abroad from the establishment of these databases to January 3, 2023, and searched for the randomized controlled trials about laparoscopic treatment (experimental group) and traditional open surgery (control group) of patients with external abdominal hernia. A total of 468 relevant literatures were collected. Data extraction and quality evaluation were conducted for the clinical studies that met the inclusion criteria; meta-analysis was performed on the included literatures using the Review Manager 5.4 software. Results　Finally, 13 literatures were included, with a total of 1 044 patients, including 527 in the experimental group and 517 in the control group. The results of meta-analysis showed that the hospitalization time in the experimental group was shorter than that in the control group, with a statistical difference (SMD=-2.16, 95%CI -2.36- -1.96, Z=21.20, P<0.000 01). The incidence of clinical complications in the experimental group was lower than that in the control group, with a statistical difference (OR=0.21,95%CI 0.13-0.34, Z=6.25, P<0.000 01). The incidence of postoperative infection in the experimental group was lower than that in the control group (P<0.000 01). Compared with the control group, the experimental group had more advantages in improving postoperative urinary retention, postoperative pain, and hematoma (all P<0.000 01). Conclusion　Compared with traditional open surgery, laparoscopic hernia repair shortens the hospitalization time, reduces postoperative complications, and improves the patients' quality of life.

Key words:

Abdominal hernia, Laparoscope, Open surgery, Randomized controlled trial, Meta-analysis

摘要：

目的　系统评价腹腔镜与传统开放型手术方式治疗腹外疝的临床疗效，为寻求更佳治疗方法及寻求循证医学提供支持。方法　全面检索各数据库建库以来至2023年1月3日国内外发表治疗腹外疝的相关文献，搜索以腹腔镜下行疝修补术为试验组、传统开放型手术为对照组的随机对照试验，共检获相关文献468篇。对符合纳入标准的临床研究进行资料提取与质量评价，采用Review Manager 5.4软件对所纳入文献进行meta分析。结果　最终纳入文献13篇，累计1 044例患者，试验组527例，对照组517例。meta分析结果显示：试验组的住院时间短于对照组，差异有统计学意义［SMD=-2.16，95%CI -2.36～-1.96，Z＝21.20，P<0.000 01］；试验组的临床并发症发生率低于对照组，差异有统计学意义［OR＝0.21，95%CI 0.13～0.34，Z=6.25，P<0.000 01］；试验组术后感染发生率低于对照组（均P<0.000 01）；与对照组比较，试验组在改善术后尿潴留、改善术后疼痛及血肿方面更有优势（均P<0.000 01）。结论　在腹腔镜下行疝修补术较传统开放型手术住院时间缩短，能降低术后并发症发生率，改善患者生活质量。

关键词:

腹外疝, 腹腔镜, 开放型手术, 随机对照试验, meta分析