Berndsen F, Arvidsson D, Enander L K, Leijonmarck C E, Wingren U, Rudberg C, Smedberg S, Wickbom G, Montgomery A
Department of Surgery, Malmö University Hospital, Sweden.
Hernia. 2002 Jul;6(2):56-61. doi: 10.1007/s10029-002-0055-3.
Interest in inguinal hernia surgery has increased significantly with the introduction of new operating techniques during the past decade. This multicenter study compared short-term results in patients treated by the laparoscopic transabdominal preperitoneal patch technique (TAPP; n = 518) and the Shouldice technique (n = 524). We evaluated demographics, operative data, complications, hospital stay, postoperative pain, use of cs, functional status, sick leave, and complaints up to 3 months postoperatively. The median operating time was shorter in the Shouldice group (55 vs. 65 min), but there were no significant differences in complication rates, and major complications were rare. The hospital stay was 1 day or less in over 98% of cases in both groups, but more operations were performed on outpatient basis in the Shouldice group. In the TAPP group postoperative pain and analgesic consumption were less, postoperative functional status was better, and sick leave was shorter (10 vs. 14 days). These results show that the two methods are equally safe and have few major complications. The TAPP operation is associated with less postoperative pain, better postoperative functional status, and shorter sick leave, but at the price of a longer operating time.
在过去十年中,随着新手术技术的引入,腹股沟疝手术的关注度显著提高。这项多中心研究比较了采用腹腔镜经腹腹膜前修补术(TAPP;n = 518)和Shouldice术(n = 524)治疗的患者的短期结果。我们评估了人口统计学数据、手术数据、并发症、住院时间、术后疼痛、阿片类药物使用情况、功能状态、病假情况以及术后3个月内的不适主诉。Shouldice组的中位手术时间较短(55分钟对65分钟),但并发症发生率无显著差异,且严重并发症罕见。两组超过98%的病例住院时间为1天或更短,但Shouldice组更多手术在门诊进行。在TAPP组,术后疼痛和阿片类药物消耗量更少,术后功能状态更好,病假时间更短(10天对14天)。这些结果表明,两种方法同样安全,严重并发症较少。TAPP手术术后疼痛更少,术后功能状态更好,病假时间更短,但代价是手术时间更长。