Vanclooster P, Smet B, de Gheldere C, Segers K
Department of general and abdominal surgery, Hospital H. Hart, Kolveniersvest 20, 2500 Lier, Belgium.
Acta Chir Belg. 2001 May-Jun;101(3):135-8.
Since 6 years, the totally extraperitoneal laparoscopic hernia repair has become our procedure of choice to manage inguinal hernia in adult patients, especially for bilateral hernias and recurrences after classical anterior repair. Between March 1993 and March 1999, 976 patients underwent 1259 hernia repairs by an endoscopic total extraperitoneal approach. A large polypropylene prosthesis (15 x 15 cm) is placed and covers all potential defects. Follow-up on patients ranged from 6 to 79 months (mean, 39 months). Per- and postoperative morbidity and complications were acceptable (8.4%) and included conversion to open surgery (0.4%), bleedings (0.3%), urinary retention (4.2%), seromas (2.7%), neuralgias (0.2%), vague persistent groin discomfort (0.4%), orchitis (0.08%) and sigmoido-cutaneous fistula (0.08%). Recurrence rate so far is 0.1%. This retrospective study shows that the totally extraperitoneal repair for inguinal hernia should have a promising future because of low morbidity and low recurrence rate.
6年来，完全腹膜外腹腔镜疝修补术已成为我们治疗成年患者腹股沟疝的首选术式，尤其适用于双侧疝以及经典前路修补术后的复发疝。1993年3月至1999年3月期间，976例患者通过内镜完全腹膜外入路接受了1259次疝修补术。放置一块大的聚丙烯补片（15×15cm），覆盖所有潜在缺损。患者的随访时间为6至79个月（平均39个月）。围手术期及术后的发病率和并发症均可接受（8.4%），包括中转开放手术（0.4%）、出血（0.3%）、尿潴留（4.2%）、血清肿（2.7%）、神经痛（0.2%）、持续的腹股沟区隐痛（0.4%）、睾丸炎（0.08%）和乙状结肠皮肤瘘（0.08%）。目前的复发率为0.1%。这项回顾性研究表明，由于发病率低和复发率低，腹股沟疝的完全腹膜外修补术应有一个光明的前景。
