O'Riordain D S, Kelly P, Horgan P G, Keane F B, Tanner W A
Department of Surgery, Meath and Adelaide Hospitals and Trinity College, Heytesbury Street, Dublin 8, Ireland.
Surg Endosc. 1999 Sep;13(9):914-7. doi: 10.1007/s004649901133.
Totally extraperitoneal (TEP) laparoscopic inguinal hernia repair is gaining popularity, and our preference is to perform this procedure as a day case. This study evaluates the suitability of TEP repair in the day-care setting.
A policy of day-care TEP repair, unless contraindicated, was adopted for inguinal hernia repair, and the outcome was prospectively evaluated. Of 87 consecutive inguinal hernia repairs, day-care TEP was possible in 54 (62%); 17 (20%) were in-patient TEP, 14 (16%) were open repairs, and 2 (2%) were converted from TEP to open repairs.
Among day-care TEP repairs, median visual analog pain score at discharge was 2.3/10, and 43% of patients had no pain. Complications included cord hematoma 2 (4%) and seroma 3 (6%). Median times for stopping analgesia, resumption of full activity, and return to work were 3, 3, and 6 days respectively. Complete satisfaction with day-care TEP was expressed by 91% of patients; 9% were moderately satisfied, and none expressed dissatisfaction.
Day-care TEP repair is feasible in the majority of patients with inguinal hernias, and it is associated with minimal complications, excellent recovery, and a high degree of patient satisfaction.
完全腹膜外（TEP）腹腔镜腹股沟疝修补术越来越受欢迎，我们更倾向于将此手术作为日间手术进行。本研究评估了TEP修补术在日间护理环境中的适用性。
对腹股沟疝修补术采用日间护理TEP修补政策，除非有禁忌证，并对结果进行前瞻性评估。在连续87例腹股沟疝修补术中，54例（62%）可行日间护理TEP；17例（20%）为住院TEP，14例（16%）为开放修补术，2例（2%）由TEP转为开放修补术。
在日间护理TEP修补术中，出院时视觉模拟疼痛评分中位数为2.3/10，43%的患者无疼痛。并发症包括精索血肿2例（4%）和血清肿3例（6%）。停止镇痛、恢复完全活动和恢复工作的中位时间分别为3天、3天和6天。91%的患者对日间护理TEP完全满意；9%的患者中度满意，无人表示不满意。
日间护理TEP修补术对大多数腹股沟疝患者是可行的，且并发症最少，恢复良好，患者满意度高。
