Sayad P, Ferzli G
Department of Laparoscopic Surgery, Staten Island University Hospital, New York, USA.
J Laparoendosc Adv Surg Tech A. 1999 Apr;9(2):127-30. doi: 10.1089/lap.1999.9.127.
Repair of recurrent inguinal hernias using the conventional open technique has been associated with high rates of recurrence and complications. Stoppa has reported a low recurrence rate using the open preperitoneal approach. Evolution of laparoscopic techniques has allowed the reproduction of the open preperitoneal repair via an endoscopic totally extraperitoneal (TEP) approach. This study reviewed all the recurrent inguinal hernias repaired laparoscopically and evaluated the complication and recurrence rate. A total of 512 inguinal hernias were treated laparoscopically using the TEP approach. Of these, 75 were recurrent. The ages of the 61 men ranged from 36 to 65 years. There were 41 direct and 34 indirect hernias. Fourteen were bilateral. None of the repairs was converted to an open procedure. The operating time ranged from 20 to 145 min (median 42 min). All patients were discharged home on the same day. There were no deaths. The complications consisted of two instances of urinary retention and one groin collection. Patient follow-up ranged from 6 to 72 (median 40) months, and there have been no recurrences to date. The TEP repair for recurrent inguinal hernias can produce results comparable to the open preperitoneal technique with low morbidity and recurrence rates.
采用传统开放技术修复复发性腹股沟疝与高复发率和并发症相关。斯托帕报告使用开放腹膜前入路复发率较低。腹腔镜技术的发展使得通过内镜完全腹膜外（TEP）入路重现开放腹膜前修复成为可能。本研究回顾了所有通过腹腔镜修复的复发性腹股沟疝，并评估了并发症和复发率。共有512例腹股沟疝采用TEP入路进行腹腔镜治疗。其中，75例为复发性疝。61名男性患者年龄在36至65岁之间。有41例直疝和34例斜疝。14例为双侧疝。所有修复均未转为开放手术。手术时间为20至145分钟（中位数42分钟）。所有患者均于同日出院。无死亡病例。并发症包括2例尿潴留和1例腹股沟积液。患者随访时间为6至72个月（中位数40个月），迄今为止无复发。复发性腹股沟疝的TEP修复可产生与开放腹膜前技术相当的结果，且发病率和复发率较低。
