Szymanski J, Voitk A
Department of Surgery, The Scarborough Hospital, Ontario, Canada.
Am Surg. 2001 Feb;67(2):155-8.
This study attempts to determine by independent review the results of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair for hernias with increased risk for recurrence. Indicators used for increased recurrence risk were recurrent hernias or simultaneously repaired bilateral inguinal hernias. Office and hospital records of all such patients who had undergone TAPP repair were reviewed from one surgeon's 242-patient laparoscopic inguinal hernia database from 1992 to 1998. All were called for assessment by an independent surgeon at least 4 months postoperatively (median 34 months). Those unable to come in person were interviewed by telephone. There were 121 hernias: 34 recurrent and 100 bilateral (13 overlap). Recurrence rate was 3 per cent, which was similar for repair of bilateral and recurrent hernias. All recurrences occurred within 3 months of surgery. No unknown recurrence was detected by the independent observer. Laparoscopic TAPP inguinal hernia repair, often claimed as the method of choice for bilateral and recurrent hernia repair, is indeed a safe and effective procedure with a low early recurrent rate in these higher-risk situations.
本研究试图通过独立评估来确定腹腔镜经腹腹膜前（TAPP）腹股沟疝修补术治疗复发风险增加的疝的效果。用于评估复发风险增加的指标为复发性疝或同时修补双侧腹股沟疝。从一位外科医生1992年至1998年的242例腹腔镜腹股沟疝数据库中，回顾了所有接受TAPP修补术的此类患者的门诊和住院记录。所有患者在术后至少4个月（中位时间34个月）由一位独立外科医生进行评估。无法亲自前来的患者通过电话接受访谈。共有121例疝：34例复发性疝和100例双侧疝（13例重叠）。复发率为3%，双侧疝和复发性疝修补的复发率相似。所有复发均发生在术后3个月内。独立观察者未发现隐匿性复发。腹腔镜TAPP腹股沟疝修补术常被认为是双侧疝和复发性疝修补的首选方法，在这些高风险情况下，它确实是一种安全有效的手术，早期复发率较低。
