Eklund A, Rudberg C, Leijonmarck C-E, Rasmussen I, Spangen L, Wickbom G, Wingren U, Montgomery A
Department of Surgery, Västerås Hospital, 721 89, Västerås, Sweden.
Surg Endosc. 2007 Apr;21(4):634-40. doi: 10.1007/s00464-006-9163-y. Epub 2007 Feb 16.
The optimal treatment for recurrent inguinal hernia is of concern due to the high frequency of recurrence.
This randomized multicenter study compared the short- and long-term results for recurrent inguinal hernia repair by either the laparoscopic transabdominal preperitoneal patch (TAPP) procedure or the Lichtenstein technique.
A total of 147 patients underwent surgery (73 TAPP and 74 Lichtenstein). The operating time was 65 min (range, 23-165 min) for the TAPP group and 64 min (range, 25-135 min) for the Lichtenstein group. Patients who underwent TAPP reported significantly less postoperative pain and shorter sick leave (8 vs 16 days). The recurrence rate 5 years after surgery was 19% for the TAPP group and 18% for the Lichtenstein group.
The short-term advantage for patients who undergo the laparoscopic technique is less postoperative pain and shorter sick leave. In the long term, no differences were observed in the chronic pain or recurrence rate.
由于复发频率高，复发性腹股沟疝的最佳治疗方法备受关注。
这项随机多中心研究比较了腹腔镜经腹腹膜前修补术（TAPP）和利希滕斯坦技术修复复发性腹股沟疝的短期和长期结果。
共有147例患者接受了手术（73例行TAPP，74例行利希滕斯坦手术）。TAPP组的手术时间为65分钟（范围23 - 165分钟），利希滕斯坦组为64分钟（范围25 - 135分钟）。接受TAPP手术的患者术后疼痛明显减轻，病假时间更短（分别为8天和16天）。术后5年，TAPP组的复发率为19%，利希滕斯坦组为18%。
接受腹腔镜技术治疗的患者短期优势在于术后疼痛减轻和病假时间缩短。从长期来看，慢性疼痛或复发率方面未观察到差异。
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