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复发性腹股沟疝:十年回顾

Recurrent inguinal hernia: a ten-year review.

作者信息

Feliu Xavier, Jaurrieta Eduardo, Viñas Xavier, Macarulla Enric, Abad Joseph Maria, Fernández-Sallent Enrique

机构信息

Hospital General d'Igualada, Barcelona, Spain.

出版信息

J Laparoendosc Adv Surg Tech A. 2004 Dec;14(6):362-7. doi: 10.1089/lap.2004.14.362.

Abstract

BACKGROUND

This study evaluates the results obtained in recurrent inguinal hernia repair over the past ten years in a general hospital using laparoscopic (LAP) and open tension-free mesh (Lichtenstein) procedures.

METHODS

A prospective controlled study with 258 recurrent inguinal hernias in 235 patients over a ten-year period. The main outcome measurements were recurrence rate, operating time, hospital stay, postoperative complications, and cost.

RESULTS

There were 10 recurrences (4.3%): 7 in the Lichtenstein group (5.7%) and 3 (2.2%) in the LAP group (P = nonsignificant [NS]). There were 15 (12.2%) postoperative complications in the Lichtenstein group and 6 (4.4%) in the LAP group (P =0.04). The operating room costs were higher in the LAP group, but this difference was offset by a significantly shorter hospital stay, shorter operating time, and earlier return to work.

CONCLUSION

Laparoscopic repair is an effective option for the treatment of recurrent inguinal hernia. The TEP approach combines the advantages of minimal invasive surgery and those of tension-free mesh repair, reducing operating time, postoperative morbidity, and recurrence rate.

摘要

背景

本研究评估了一家综合医院在过去十年中使用腹腔镜(LAP)和开放无张力修补术(Lichtenstein)治疗复发性腹股沟疝的结果。

方法

一项前瞻性对照研究,在十年期间对235例患者的258例复发性腹股沟疝进行研究。主要观察指标为复发率、手术时间、住院时间、术后并发症和费用。

结果

有10例复发(4.3%):Lichtenstein组7例(5.7%),LAP组3例(2.2%)(P =无显著性差异[NS])。Lichtenstein组有15例(12.2%)术后并发症,LAP组有6例(4.4%)(P =0.04)。LAP组手术室费用较高,但住院时间显著缩短、手术时间缩短和恢复工作较早抵消了这一差异。

结论

腹腔镜修补术是治疗复发性腹股沟疝的有效选择。TEP方法结合了微创手术和无张力修补术的优点,减少了手术时间、术后发病率和复发率。

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