Department of Surgery, Beppu Medical Center, Beppu, Oita, Japan.
Hernia. 2010 Oct;14(5):481-4. doi: 10.1007/s10029-010-0690-z. Epub 2010 Jun 11.
Although laparoscopic total extraperitoneal repair (TEP) has been reported to have a low recurrence rate and relatively little postoperative pain, there have been few studies reported regarding contralateral occurrence after TEP. Although a high incidence of occult contralateral hernias has been reported in the literature, it is unknown whether occult hernias have any significance in clinical settings. The aim of this study was to evaluate the incidence of contralateral occurrence after TEP for unilateral inguinal hernia.
We retrospectively reviewed the medical charts of 157 TEPs between April 2003 and May 2009. No patients had undergone contralateral exploration during TEP for unilateral inguinal hernias.
Five (3.2%) of 157 unilateral TEPs developed a hernia on the contralateral side. In three patients, the initial hernia was on the right side, and in two it was on the left side. In four patients the initial hernia was indirect, and in one it was direct. The mean duration to contralateral occurrence was 12.2 months. Three patients had contralateral occurrence within 6 months after the primary TEP, while in two over a year passed before contralateral occurrence. All five patients had undergone TEP for contralateral occurrence. The mean operation time was 87.2 min, and there was little intraoperative blood loss. There were no complications during and after the second TEP.
The incidence of contralateral occurrence after TEP was found to be low. TEP is a valuable procedure with a low contralateral occurrence rate, and repeated TEP for contralateral occurrence can be performed easily.
尽管腹腔镜完全腹膜外修补术（TEP）已被报道具有较低的复发率和相对较少的术后疼痛，但关于 TEP 后对侧发生的研究较少。尽管文献中报道了隐匿性对侧疝的发生率较高，但尚不清楚隐匿性疝在临床环境中是否有任何意义。本研究旨在评估单侧腹股沟疝 TEP 后对侧发生的发生率。
我们回顾性分析了 2003 年 4 月至 2009 年 5 月期间 157 例 TEP 的病历。在单侧腹股沟疝的 TEP 中，没有患者进行对侧探查。
157 例单侧 TEP 中有 5 例（3.2%）发生对侧疝。在 3 例患者中，最初的疝位于右侧，在 2 例患者中位于左侧。在 4 例患者中，最初的疝为间接疝，在 1 例患者中为直接疝。对侧发生的平均时间为 12.2 个月。3 例患者在初次 TEP 后 6 个月内发生对侧发生，而在 2 例患者中，在 1 年以上时间才发生对侧发生。所有 5 例患者均因对侧发生而行 TEP。第二次 TEP 的平均手术时间为 87.2 分钟，术中出血量很少。第二次 TEP 期间和之后均无并发症。
TEP 后对侧发生的发生率较低。TEP 是一种具有较低对侧发生率的有价值的手术，并且可以轻松进行重复 TEP 治疗对侧发生。
