Choi Yoon Young, Han Sun Wook, Bae Sang Ho, Kim Sung Yong, Hur Kyung Yul, Kang Gil Ho
Department of Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
J Korean Surg Soc. 2012 Jan;82(1):40-4. doi: 10.4174/jkss.2012.82.1.40. Epub 2011 Dec 27.
To compare the outcomes between laparoscopic total extraperitoneal (TEP) repair and prolene hernia system (PHS) repair for inguinal hernia.
A retrospective analysis of 237 patients scheduled for laparoscopic TEP or PHS repair of groin hernia from 2005 to 2009 was performed.
The mean age was 52.3 years in TEP group and 55.7 years in PHS group. Of 119 TEP cases, 98 were indirect inguinal hernia, 15 direct type, 5 femoral hernia and 1 complex hernia; Of 118 PHS cases, 100 indirect, 18 direct type. All in TEP group were performed under general anesthesia and 64% of PHS group were performed under spinal or epidural anesthesia. Preoperatively, 10 cases of recurrent inguinal hernia were involved in our study (4 in TEP, 6 in PHS group). The mean operative time was similar in both groups (74.8 in TEP, 71.2 in PHS group), however mean hospital stay (1.6 days in TEP, 3.2 days in PHS group, P = 0.018) and mean usage of analgesics (0.54 times in TEP, 2.03 times in PHS group, P < 0.01), complications (36 cases in TEP, 6 cases in PHS group, P < 0.01) showed statistical differences. There is only 1 case of postoperative recurrence inguinal hernia in PHS group but it has no statistical significance (P = 0.314).
Compared to PHS repair, laparoscopic TEP repair has some advantages; shorter hospital stay, less frequent need of analgesics; as well as more postoperative complications such as hematoma, seroma, scrotal swelling.
比较腹腔镜完全腹膜外(TEP)修补术与普理灵疝修补系统(PHS)修补术治疗腹股沟疝的疗效。
对2005年至2009年计划行腹腔镜TEP或PHS修补术治疗腹股沟疝的237例患者进行回顾性分析。
TEP组平均年龄为52.3岁,PHS组为55.7岁。119例TEP病例中,98例为腹股沟斜疝,15例为直疝,5例为股疝,1例为复合疝;118例PHS病例中,100例为腹股沟斜疝,18例为直疝。TEP组均在全身麻醉下进行,PHS组64%在脊髓或硬膜外麻醉下进行。术前,本研究纳入10例复发性腹股沟疝患者(TEP组4例,PHS组6例)。两组平均手术时间相似(TEP组74.8分钟,PHS组71.2分钟),但平均住院时间(TEP组为1.6天,PHS组为3.2天,P = 0.018)、平均镇痛药使用次数(TEP组为0.54次,PHS组为2.03次,P < 0.01)、并发症(TEP组36例,PHS组6例,P < 0.01)存在统计学差异。PHS组仅1例术后复发性腹股沟疝,但无统计学意义(P = 0.314)。
与PHS修补术相比,腹腔镜TEP修补术具有一些优势;住院时间短,镇痛药使用频率低;但术后并发症较多。如血肿、血清肿、阴囊肿胀。