Vidović Dinko, Kirac Iva, Glavan Elizabet, Filipović-Cugura Jaksa, Ledinsky Mario, Bekavac-Beslin Miroslav
Department of Surgery, University Hospital, Sisters of Charity, Vinogradska 29, 10000 Zagreb, Croatia.
J Laparoendosc Adv Surg Tech A. 2007 Oct;17(5):585-90. doi: 10.1089/lap.2006.0186.
Whereas open Lichtenstein inguinal herniorrhaphy is generally accepted as a safe, well-understood method with a high success rate, the laparoscopic repair of a inguinal hernia is a fairly recent technique. Although the laparoscopic approach to a hernia repair procedure is associated with less pain and faster recovery than open repair, many surgeons are not familiar with this technique owing to technical demands and a long learning curve. This study compares the results and complications between open tension-free mesh (Lichtenstein) repair and laparoscopic total extraperitoneal (TEP) repair. The study cohort was comprised of 345 consecutive patients who underwent an inguinal herniorraphy procedure. An open hernia repair was performed on one group of patients (n = 233), whereas TEP repair was performed on the other (n = 112), and then the comparison of intra- and postoperative complications and results obtained from both techniques was done. The mean hospital stay was similar in both groups. The average operative time in the TEP group was 58.6 +/- 18.1 minutes, and the average operative time in the open group was 58.2 +/- 17.8 minutes. There was no difference in postoperative complication rates between the two groups, except for urinary retention, which patients who underwent TEP repair were more likely to get. The following major complications were recorded: 2 cases of urinary bladder perforation-1 during TEP repair and the other during Lichtenstein repair, but both with good postoperative outcome-and 1 case of pneumothorax, which occurred during the TEP procedure. Despite the fact that TEP is a demanding procedure, it may be performed efficiently with an acceptable operating time and a low complication rate.
虽然开放式利chtenstein腹股沟疝修补术通常被认为是一种安全、易于理解且成功率高的方法，但腹腔镜腹股沟疝修补术是一种相当新的技术。尽管与开放式修补相比，腹腔镜疝修补手术的方法疼痛较轻且恢复较快，但由于技术要求和较长的学习曲线，许多外科医生并不熟悉这项技术。本研究比较了开放式无张力网片（利chtenstein）修补术和腹腔镜完全腹膜外（TEP）修补术的结果及并发症。研究队列由345例连续接受腹股沟疝修补手术的患者组成。一组患者（n = 233）接受开放式疝修补术，另一组（n = 112）接受TEP修补术，然后对两种技术的术中及术后并发症和结果进行比较。两组的平均住院时间相似。TEP组的平均手术时间为58.6 +/- 18.1分钟，开放组的平均手术时间为58.2 +/- 17.8分钟。两组术后并发症发生率无差异，但TEP修补术患者更易发生尿潴留。记录了以下主要并发症：2例膀胱穿孔——1例在TEP修补术中发生，另1例在利chtenstein修补术中发生，但术后结果均良好——以及1例气胸，发生在TEP手术过程中。尽管TEP手术要求较高，但可以在可接受的手术时间和低并发症发生率的情况下有效进行。
