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内镜全腹膜外修补复发性腹股沟疝:5 年回顾。

Endoscopic total extraperitoneal repair of recurrent inguinal hernia: a 5-year review.

机构信息

Minimally Invasive Surgical Centre, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

出版信息

Hernia. 2010 Oct;14(5):477-80. doi: 10.1007/s10029-010-0675-y. Epub 2010 May 21.

Abstract

PURPOSE

The experience of endoscopic total extraperitoneal (TEP) repair of recurrent inguinal hernia in a major teaching hospital is reviewed.

METHODS

Between 2003 and 2008, 37 consecutive patients underwent 46 TEP repairs for recurrent inguinal hernia. Patient demographics, hernia characteristics, operating time, conversion rate, intraoperative, postoperative complications and recurrence were measured. Twenty-eight patients had unilateral hernia and nine patients had bilateral hernias. The mean age was 59 years old (range 22-88 years).

RESULTS

The mean operation duration was 88 min (range 60-120 min). Bilateral repairs took 38% longer than for unilateral repairs (108 vs 78 min). Three patients (8.1%) had conversion to open surgery. Seroma developed in two patients, which was subsequently resolved. Within 1 year of follow up evaluation, there was 1 recurrence (2.7%). The mean inpatient hospital stay was 1.6 days, and 24.3% of the operations were performed as outpatients.

CONCLUSION

Repair of recurrent hernia using the TEP approach can be achieved with minimum morbidity, good clinical outcomes and acceptable recurrence rates. Endoscopic repair has become the procedure of choice for the treatment of the majority of recurrent inguinal hernias at our institution.

摘要

目的

回顾在一所大型教学医院行内镜全腹膜外(TEP)修复复发性腹股沟疝的经验。

方法

2003 年至 2008 年间,37 例连续患者接受了 46 例 TEP 修复复发性腹股沟疝。测量了患者的人口统计学特征、疝特征、手术时间、转化率、术中、术后并发症和复发情况。28 例患者为单侧疝,9 例患者为双侧疝。平均年龄为 59 岁(范围 22-88 岁)。

结果

平均手术时间为 88 分钟(范围 60-120 分钟)。双侧修复比单侧修复长 38%(108 分钟比 78 分钟)。3 例患者(8.1%)转为开放手术。2 例患者出现血清肿,随后得到解决。在随访评估的 1 年内,有 1 例复发(2.7%)。平均住院时间为 1.6 天,24.3%的手术为门诊手术。

结论

使用 TEP 方法修复复发性疝可实现最小的发病率、良好的临床结果和可接受的复发率。在我们的机构,内镜修复已成为治疗大多数复发性腹股沟疝的首选方法。

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