Taylor Craig John, Wilson Tim
Peninsula Private Hospital, Sydney, New South Wales, Australia.
ANZ J Surg. 2005 Aug;75(8):637-9. doi: 10.1111/j.1445-2197.2005.03487.x.
The short-term advantages of laparoscopic totally extraperitoneal mesh herniorrhaphy (TEP) are well documented, but the long-term results remain unclear. The purpose of the present paper is to clarify this issue with particular reference to hernia recurrence and chronic pain.
A retrospective case series of 100 consecutive patients undergoing TEP 5 years ago by a single surgeon were followed up prospectively with a focused physical examination and interview. Data collected included recurrence, chronic groin pain, tenderness, sensory disturbance, activity or occupational limitation, and personal satisfaction.
During the period between 1997 and 1999, 100 consecutive patients underwent 110 TEP hernia repairs. The mean age was 56 years. Two patients were excluded from the study because they had had open repairs for technical reasons. Median follow up was 64 months. Follow up was complete (interview and physical examination) in 88% and partial (telephone interview only) in a further 5%. There was no major morbidity or mortality. Hernia recurrence rate was 1%. Chronic pain occurred in 14 patients (14%), which was mild in 13 patients and moderate in one. Ninety-eight per cent of patients were satisfied with their repair and would or had recommended TEP to others.
Long-term results of TEP demonstrate it to be an effective and safe procedure with a low recurrence and low prevalence of chronic pain that is generally of a mild, infrequent nature.
腹腔镜完全腹膜外疝修补术（TEP）的短期优势已有充分记录，但长期结果仍不明确。本文旨在通过特别提及疝复发和慢性疼痛来阐明这一问题。
对5年前由一位外科医生连续进行TEP手术的100例患者进行回顾性病例系列研究，并通过针对性的体格检查和访谈进行前瞻性随访。收集的数据包括复发情况、慢性腹股沟疼痛、压痛、感觉障碍、活动或职业限制以及个人满意度。
在1997年至1999年期间，100例连续患者接受了110次TEP疝修补术。平均年龄为56岁。两名患者因技术原因接受了开放修补术而被排除在研究之外。中位随访时间为64个月。88%的患者完成了随访（包括访谈和体格检查），另有5%的患者仅进行了电话访谈。无重大并发症或死亡病例。疝复发率为1%。14例患者（14%）出现慢性疼痛，其中13例为轻度，1例为中度。98%的患者对其修补手术满意，并会或已经向他人推荐TEP。
TEP的长期结果表明，它是一种有效且安全的手术，复发率低，慢性疼痛发生率低，且通常为轻度、不常见。
