Czechowski A, Schafmayer A
Chirurgische Klinik, Städtisches Klinikum Lüneburg.
Chirurg. 2003 Dec;74(12):1143-9. doi: 10.1007/s00104-003-0738-z.
The 5-year results after laparoscopic repair of inguinal and femoral hernias with the TAPP and TEP techniques were analyzed.
We examined all patients after inguinal repair with the TAPP or TEP technique for the treatment of inguinal and/or femoral hernias from September 1992 to February 1996 performed by four surgeons at the Lüneburg community hospital (TAPP: 294 patients with 352 hernias, TEP: 278 patients with 324 hernias). The follow-up included a clinical examination, a questionnaire, and an ultrasound examination of the inguinal area.
The follow-up rate was 93.5% after TAPP and 91% after TEP with a median follow-up of 5.7 postoperative years. With a total complication rate of almost 10.2% both methods did not differ. The recurrence rate after TAPP was 2.3% ( re-recurrence rate 6.7%) and 1.5% after TEP ( re-recurrence rate 4.8%). Recurrences occurred on average 45 months after TAPP and 36.6 months after TEP.
TAPP and TEP are both safe and efficient. Because of the late occurrence of recurrence we suggest randomized prospective studies over a period of 5-10 postoperative years.
分析采用经腹腹膜前修补术(TAPP)和完全腹膜外修补术(TEP)技术腹腔镜修补腹股沟疝和股疝的5年结果。
我们检查了1992年9月至1996年2月在吕讷堡社区医院由四位外科医生采用TAPP或TEP技术进行腹股沟疝修补术治疗腹股沟疝和/或股疝的所有患者(TAPP:294例患者,352处疝;TEP:278例患者,324处疝)。随访包括临床检查、问卷调查以及腹股沟区超声检查。
TAPP术后随访率为93.5%,TEP术后为91%,术后中位随访时间为5.7年。两种方法的总并发症发生率接近10.2%,无差异。TAPP术后复发率为2.3%(再复发率6.7%),TEP术后为1.5%(再复发率4.8%)。TAPP术后复发平均发生在45个月后,TEP术后为36.6个月后。
TAPP和TEP均安全有效。由于复发出现较晚,我们建议在术后5至10年进行随机前瞻性研究。