McNally Michael P, Byrd Kevin A, Duncan James E, Shepps Craig D
Expeditionary Medical Facility Kuwait, Department of Surgery, Camp Arifjan, Kuwait APO AE 09366.
Mil Med. 2009 Dec;174(12):1320-3. doi: 10.7205/milmed-d-00-5109.
Inguinal hernia is a common surgical problem in the active duty population. The decision to perform a hernia repair in the traditional open manner versus a laparoscopic approach is somewhat controversial. Furthermore, the type of repair performed has not been analyzed in a systematic manner within an operational setting.
We retrospectively reviewed all inguinal hernia repairs performed at Expeditionary Medical Facility Kuwait (EMFK) over an 18-month period, from April 2007 through October 2008. Operative times and time to return to duty were compared between active duty personnel undergoing open mesh repair and laparoscopic extraperitoneal inguinal hernia repair.
One hundred seventy-six consecutive patients who underwent inguinal hernia repair by six different surgeons were analyzed. One hundred and four patients had an open repair and 72 patients underwent laparoscopic repair. The mean operative time was significantly longer in the laparoscopic group (20.2 minutes, p < 0.001). The mean time to return to duty was significantly shorter in the laparoscopic group (2.3 days, p = 0.008).
Laparoscopic inguinal hernia repair is associated with longer operative times but shorter recovery periods. The laparoscopic approach may be a viable option for patients in the expeditionary setting.
腹股沟疝是现役人群中常见的外科问题。采用传统开放方式还是腹腔镜方式进行疝修补术的决策存在一定争议。此外，在作战环境中尚未对所进行的修补类型进行系统分析。
我们回顾性分析了2007年4月至2008年10月期间在科威特远征医疗设施（EMFK）进行的所有腹股沟疝修补术。比较了接受开放网片修补术和腹腔镜腹膜外腹股沟疝修补术的现役人员的手术时间和恢复执勤时间。
分析了由六位不同外科医生进行腹股沟疝修补术的176例连续患者。104例患者接受开放修补术，72例患者接受腹腔镜修补术。腹腔镜组的平均手术时间明显更长（20.2分钟，p<0.001）。腹腔镜组的平均恢复执勤时间明显更短（2.3天，p = 0.008）。
腹腔镜腹股沟疝修补术手术时间较长，但恢复期较短。对于远征环境中的患者，腹腔镜方法可能是一种可行的选择。
