Smith J R, Demers M L, Pollack R, Gregory S
Orlando Regional Medical Center, Florida, USA.
Am Surg. 2001 Feb;67(2):115-7; discussion 117-8.
Controversy persists regarding the most effective inguinal hernia repair. The purpose of this study is to compare the complications, charges, patient satisfaction, and recovery time between laparoscopic (LH) and open mesh herniorrhaphy (OH). A nonrandomized prospective analysis of 233 consecutive inguinal hernia repairs was performed over a 12-month period by 27 surgeons. The type of repair was determined by surgeon preference. Cost analysis was performed using anesthesia records and hospital cost. Patient satisfaction and recovery time were evaluated by third-party interview. A total of 113 OHs and 120 LHs were performed; 11 OHs and 42 LHs were bilateral. Patient demographics were equivalent for the two groups. No statistical difference was noted when comparing anesthesia/operating room time between the two groups. The LHs accrued an additional charge of $2254 per case. Complication rates were 4.4 per cent for the OHs and 8.3 per cent for the LHs. All complications were considered minor. No infectious complications or recurrences were noted in either group. Satisfaction rates and pain indices were nearly identical for both OHs and LHs. The LHs had a shorter recovery time by 5.5 days. We conclude that LH is associated with a higher complication rate and cost than OH. Pain indices are similar, but LH has a shorter recovery time.
关于最有效的腹股沟疝修补术仍存在争议。本研究的目的是比较腹腔镜腹股沟疝修补术（LH）和开放式无张力疝修补术（OH）在并发症、费用、患者满意度和恢复时间方面的差异。27名外科医生在12个月内对连续233例腹股沟疝修补术进行了非随机前瞻性分析。修补方式由外科医生的偏好决定。使用麻醉记录和医院费用进行成本分析。通过第三方访谈评估患者满意度和恢复时间。共进行了113例OH和120例LH；11例OH和42例LH为双侧手术。两组患者的人口统计学特征相当。两组之间比较麻醉/手术时间时未发现统计学差异。LH每例额外费用为2254美元。OH的并发症发生率为4.4%，LH为8.3%。所有并发症均为轻微并发症。两组均未发现感染性并发症或复发。OH和LH的满意度和疼痛指数几乎相同。LH的恢复时间短5.5天。我们得出结论，与OH相比，LH的并发症发生率和费用更高。疼痛指数相似，但LH的恢复时间更短。
