Olmi S, Erba L, Magnone S, Croce E
II Divisione di Chirurgia Generale, Centro di Chirurgia Laparoscopica e Mini-invasiva, Ospedale S. Gerardo, Monza (MI).
Minerva Chir. 2004 Jun;59(3):265-70.
Inguinal hernia play a major role in a general surgical division. In the last 10 years laparoscopy has gained a key role even in the treatment of this disease. This study aims to review a single institution's experience with laparoscopic transabdominal preperitoneal repair of inguinal hernia (TAPP).
A retrospective study of 715 operations in 500 patients from 1992 to September 2002. Two hundred and eight six (56.6%) of these were monolateral hernias and 214 (43.4%) were bilateral while 215 (30%) were recurrent.
Of 214 operations recurrence rate was 0.43 with a mean operating time of 30 min (range 25-50) for monolateral hernias and of 70 min (range 45-120) for bilateral hernias. Mean length of stay was 2 days (range 1-10). Return to work occurred in 6 days while sports were resumed after 10 days. Complications occurred in 40 (8.6%) patients with only 2 (0.4%) major complications. Mean follow up time was 58.3 months.
According to personal experience, and in agreement with international literature, laparoscopy showed to be effective mostly in treating bilateral and recurrent hernias, particularly for faster recovery and less postoperative pain compared to traditional techniques.
腹股沟疝在普通外科中占据重要地位。在过去十年中,腹腔镜技术在该疾病的治疗中也发挥了关键作用。本研究旨在回顾一家机构在腹腔镜经腹腹膜前修补术(TAPP)治疗腹股沟疝方面的经验。
对1992年至2002年9月期间500例患者的715例手术进行回顾性研究。其中,286例(56.6%)为单侧疝,214例(43.4%)为双侧疝,215例(30%)为复发性疝。
在214例手术中,单侧疝的复发率为0.43,平均手术时间为30分钟(范围25 - 50分钟),双侧疝的平均手术时间为70分钟(范围45 - 120分钟)。平均住院时间为2天(范围1 - 10天)。术后6天可恢复工作,10天后可恢复运动。40例(8.6%)患者出现并发症,仅2例(0.4%)为严重并发症。平均随访时间为58.3个月。
根据个人经验,并与国际文献一致,腹腔镜手术在治疗双侧和复发性疝方面显示出有效性,特别是与传统技术相比,恢复更快且术后疼痛更少。