Department of Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
World J Surg. 2013 Apr;37(4):746-51. doi: 10.1007/s00268-013-1925-9.
Recently, single port laparoscopic surgery has begun to develop as an extension of minimally invasive surgery, but there have been only a few reports of single port laparoscopic totally extraperitoneal (SPLTEP) hernioplasty. In addition, there are few comparative studies with conventional laparoscopic totally extraperitoneal (CLTEP) hernioplasty. The aim of the present study was to report our experience with SPLTEP hernioplasty and to compare short-term outcomes for SPLTEP hernioplasty with CLTEP hernioplasty.
Data were prospectively collected for all patients undergoing SPLTEP hernioplasty for inguinal hernia at Incheon St. Mary's Hospital, Incheon, Korea. Data for the SPLTEP group (n = 76 patients enrolled between June 2010 and May 2011) were compared retrospectively with data for the CLTEP group (n = 93 patients enrolled between June 2009 and May 2010).
There were no significant differences in patient demographics. This study showed no significant difference in terms of operative time between the two groups (SPLTEP group 54.0 min vs. CLTEP group 47.8 min; p = 0.07). There were no conversions to conventional TEP hernioplasty or transabdominal preperitoneal hernioplasty or open surgery in SPLTEP hernioplasty. Morbidity rates were 7.9 % (n = 6) in the SPLTEP group and 10.8 % (n = 10) in the CLTEP group, and the difference was not significant.
Single port laparoscopic totally extraperitoneal hernioplasty is technically feasible and the short-term operative outcome is comparable to that of CLTEP hernioplasty. Future large-scale prospective controlled studies and long-term analysis are needed to establish the cosmetic outcomes, quality of life, long-term recurrence rate, and long-term complication rate of SPLTEP hernioplasty.
最近，单孔腹腔镜手术已开始作为微创外科的延伸发展，但仅有少数关于经脐单孔腹腔镜完全腹膜外疝修补术（SPLTEP）的报道。此外，与传统腹腔镜完全腹膜外疝修补术（CLTEP）相比，比较研究也较少。本研究旨在报告我们的经脐单孔腹腔镜完全腹膜外疝修补术经验，并比较 SPLTEP 疝修补术与 CLTEP 疝修补术的短期结果。
在韩国仁川圣玛丽医院，前瞻性地收集了所有接受经脐单孔腹腔镜疝修补术治疗腹股沟疝的患者数据。将 SPLTEP 组（2010 年 6 月至 2011 年 5 月纳入的 76 例患者）的数据与 CLTEP 组（2009 年 6 月至 2010 年 5 月纳入的 93 例患者）的数据进行回顾性比较。
两组患者的人口统计学特征无显著差异。本研究表明，两组手术时间无显著差异（SPLTEP 组 54.0 分钟 vs. CLTEP 组 47.8 分钟；p = 0.07）。在 SPLTEP 疝修补术中，无一例转为传统 TEP 疝修补术、经腹腹膜前疝修补术或开放手术。SPLTEP 组的并发症发生率为 7.9%（n = 6），CLTEP 组为 10.8%（n = 10），差异无统计学意义。
经脐单孔腹腔镜完全腹膜外疝修补术在技术上是可行的，短期手术结果与 CLTEP 疝修补术相当。需要进行未来的大规模前瞻性对照研究和长期分析，以确定 SPLTEP 疝修补术的美容效果、生活质量、长期复发率和长期并发症发生率。
