Kwon Ki-Hwak, Son Byung-Ho, Han Won-Kon
Department of Surgery, Kangbuk Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Korean Surg Soc. 2011 May;80(5):319-26. doi: 10.4174/jkss.2011.80.5.319. Epub 2011 May 9.
We have treated 24 patients through laparoscopic totally extraperitoneal (TEP) repair without suprapubic port by using reliability and reducing the invasiveness of two surgery. This study is aimed to assess the safety and feasibility of the TEP repair without suprapubic port compared to conventional TEP repair.
From September 2007 to 11 May 2010, we compared two groups that suffer from inguinal hernias. One is comprised of 24 patients who were treated without suprapubic port laparoscopic totally extraperitoneal repair (Group A), and the other is comprised of 100 patients who were treated with conventional laparoscopic totally extraperitoneal repair (Group B). Data regarding patient demographics (sex, age, site of hernia, and the type of hernia), operating time, postoperative hospital stay, the use of analgesics, and complications were prospectively collected.
There was no significant difference noted between two groups in relation to sex, age, site, and the type of hernia. The mean operating time and postoperative hospital stay was longer for the Group B (62.9 minutes, 3.55 days) than for the Group A (59.0 minutes, 2.54 days) (P = 0.389, P < 0.001). Postoperative urinary retention, seroma, wound infection were respectively 4.2%, 8.3%, 0% in Group A, and 12.0%, 8.0%, 7% in group B. There was difference between the two groups, but not statistical significance. Group B used more analgesics than Group A (0.33 vs. 0.48), but it wasn't significant statistically (P = 0.234).
Although prospective randomized studies with long-term follow-up evaluation are needed to confirm our study between laparoscopic totally extraperitoneal repair without suprapubic-port and conventional laparoscopic totally extraperitoneal repair, our method have some advantages in postoperative pain, urinary retention, operating time, postoperative hospital stay, and cosmetic effect.
我们通过腹腔镜完全腹膜外（TEP）修补术，在不使用耻骨上端口的情况下治疗了24例患者，以提高手术的可靠性并降低其侵袭性。本研究旨在评估与传统TEP修补术相比，不使用耻骨上端口的TEP修补术的安全性和可行性。
从2007年9月至2010年5月11日，我们比较了两组腹股沟疝患者。一组由24例行不使用耻骨上端口的腹腔镜完全腹膜外修补术的患者组成（A组），另一组由100例行传统腹腔镜完全腹膜外修补术的患者组成（B组）。前瞻性收集了有关患者人口统计学资料（性别、年龄、疝的部位和疝的类型）、手术时间、术后住院时间、镇痛药使用情况及并发症的数据。
两组在性别、年龄、部位和疝的类型方面无显著差异。B组的平均手术时间和术后住院时间（分别为62.9分钟和3.55天）比A组（分别为59.0分钟和2.54天）长（P = 0.389，P < 0.001）。A组术后尿潴留、血清肿、伤口感染发生率分别为4.2%、8.3%、0%，B组分别为12.0%、8.0%、7%。两组之间存在差异，但无统计学意义。B组比A组使用更多的镇痛药（分别为0.33和0.48），但差异无统计学意义（P = 0.234）。
尽管需要进行长期随访评估的前瞻性随机研究来证实我们关于不使用耻骨上端口的腹腔镜完全腹膜外修补术与传统腹腔镜完全腹膜外修补术的研究，但我们的方法在术后疼痛、尿潴留、手术时间、术后住院时间和美容效果方面具有一些优势。
