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腹腔镜完全腹膜外(TEP)修补术治疗开放疝修补术后复发性腹股沟疝的安全性和有效性。

The safety and effectiveness of laparoscopic total extraperitoneal (TEP) repair for recurrent inguinal hernia after open hernioplasty.

作者信息

Choi Yoon Young, Kim Zisun, Hur Kyung Yul

机构信息

Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.

出版信息

J Laparoendosc Adv Surg Tech A. 2010 Jul-Aug;20(6):537-9. doi: 10.1089/lap.2010.0029.

Abstract

BACKGROUND

Many studies have reported that laparoscopic total extraperitoneal (TEP) repair for recurrent inguinal hernia after an open hernioplasty was safe and effective. This study was conducted to evaluate TEP repair for recurrent inguinal hernia through a retrospective analysis of our data.

MATERIALS AND METHODS

We performed a retrospective analysis of the medical records of patients who were scheduled for laparoscopic TEP repair from December 2000 to December 2008. A total of 1065 cases of laparoscopic TEP repairs were performed for 944 patients by a single surgeon, and 100 cases of recurrent inguinal hernias were enrolled.

RESULTS

The mean operation time was longer in the recurrent hernia group than that in the primary hernia group (P < 0.001), and peritoneal tearing occurred more frequently in the recurrent hernia group (P < 0.001). Direct hernia was more frequent in the recurrent hernia group (P < 0.001). The mean number of hospital days and complications, such as seroma and postoperative pain, were similar in both groups. Three cases of recurrence occurred (0.28%): 2 occurred in the recurrent hernia group (2%) and the other occurred in the primary hernia group (0.1%).

CONCLUSIONS

Laparoscopic TEP repair is safe and effective for treating recurrent inguinal hernia after an open hernioplasty, because the recurrence rate was low (2%) and other complications were similar for both groups. Direct inguinal hernia was more frequent in patients who had recurrent inguinal hernia.

摘要

背景

许多研究报告称,开放性疝修补术后腹腔镜完全腹膜外(TEP)修补复发性腹股沟疝是安全有效的。本研究通过对我们的数据进行回顾性分析,以评估TEP修补复发性腹股沟疝的效果。

材料与方法

我们对2000年12月至2008年12月计划进行腹腔镜TEP修补术的患者病历进行了回顾性分析。由一名外科医生为944例患者共进行了1065例腹腔镜TEP修补术,其中纳入了100例复发性腹股沟疝患者。

结果

复发性疝组的平均手术时间比原发性疝组长(P < 0.001),复发性疝组腹膜撕裂的发生率更高(P < 0.001)。复发性疝组直疝更为常见(P < 0.001)。两组的平均住院天数以及血清肿和术后疼痛等并发症相似。发生了3例复发(0.28%):2例发生在复发性疝组(2%),另1例发生在原发性疝组(0.1%)。

结论

腹腔镜TEP修补术治疗开放性疝修补术后的复发性腹股沟疝是安全有效的,因为复发率较低(2%),且两组的其他并发症相似。复发性腹股沟疝患者中直疝更为常见。

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Totally extraperitoneal repair of recurrent inguinal hernia.复发性腹股沟疝的完全腹膜外修补术
Surg Endosc. 2003 Jul;17(7):1072-6. doi: 10.1007/s00464-002-8957-9. Epub 2003 May 6.

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