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前瞻性随机试验比较腹腔镜(经腹腹膜前修补术-TAPP)与开放(网片修补)治疗双侧和复发性腹股沟疝:慢性腹股沟疼痛发生率和对生活质量的影响:10 年随访结果。

Prospective randomized trial of laparoscopic (transabdominal preperitoneal-TAPP) versus open (mesh) repair for bilateral and recurrent inguinal hernia: incidence of chronic groin pain and impact on quality of life: results of 10 year follow-up.

机构信息

Department of General Surgery, Norfolk and Norwich University Hospital, Norwich, UK.

出版信息

Hernia. 2012 Dec;16(6):635-40. doi: 10.1007/s10029-012-0940-3. Epub 2012 Jul 6.

DOI:10.1007/s10029-012-0940-3
PMID:22767210
Abstract

PURPOSE

The incidence of chronic groin pain (CGP) and its impact on quality of life (QoL) after hernia repair are not clear with follow-up either being short or retrospective. We present 10-year prospective follow-up of a randomized trial for bilateral and recurrent hernia repair focusing on CGP and its impact on QoL.

METHODS

Patients enrolled between 1997 and 2000 were contacted by telephone and asked about the presence of CGP. Those patients with CGP were sent two validated questionnaires: a SF-12v2 Health Survey and a Pain Impact Questionnaire (PIQ-6) (QualityMetric, USA).

RESULTS

One hundred and twenty patients were recruited into the original study, and of these, 14 complained of CGP and were sent a PIQ-6 and a SF-12 v2 health survey. Overall, there was a higher incidence of CGP in the laparoscopic group compared with the open group (15 vs. 8 %, ns), but the severity of the pain in the laparoscopic group was less (2 vs. 3.5, p = 0.0558). QoL was significantly reduced in patients with CGP compared with the US norm. The laparoscopic group scored higher in 5 out of 8 of the QoL categories compared with the open group, but this was not significant. Overall age-adjusted scores revealed those under 65 years of age felt they had poorer physical health, and this reduced their QoL compared to normal values.

CONCLUSION

CGP following laparoscopic surgery for inguinal hernia repair is less severe than open repair, but this does not translate into a significant improvement in QoLin this study.

摘要

目的

慢性腹股沟疼痛(CGP)的发生率及其对生活质量(QoL)的影响在随访中并不明确,随访时间要么很短,要么是回顾性的。我们报告了一项针对双侧和复发性疝修补术的前瞻性 10 年随访结果,重点关注 CGP 及其对 QoL 的影响。

方法

通过电话联系 1997 年至 2000 年间入组的患者,询问是否存在 CGP。有 CGP 的患者会被发送两个经过验证的问卷:SF-12v2 健康调查和疼痛影响问卷(PIQ-6)(QualityMetric,美国)。

结果

120 名患者被纳入原始研究,其中 14 名患者抱怨 CGP,并被发送了 PIQ-6 和 SF-12 v2 健康调查。总体而言,腹腔镜组的 CGP 发生率高于开放组(15%比 8%,无统计学意义),但腹腔镜组的疼痛程度较轻(2 分比 3.5 分,p=0.0558)。与美国正常人群相比,患有 CGP 的患者的 QoL 明显降低。与开放组相比,腹腔镜组在 8 个 QoL 类别中有 5 个类别的评分更高,但无统计学意义。总体年龄调整评分显示,65 岁以下的患者感觉身体健康状况较差,这导致他们的 QoL 与正常水平相比有所降低。

结论

腹腔镜腹股沟疝修补术后的 CGP 比开放修复术的程度较轻,但这并没有转化为 QoL 的显著改善。在本研究中。

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Quality of life analysis after open and laparoscopic inguinal hernia repair--retrospective study.开放手术与腹腔镜腹股沟疝修补术后生活质量分析——回顾性研究
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Long-term results of a randomized clinical trial of Shouldice, Lichtenstein and transabdominal preperitoneal hernia repairs.
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