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经脐单孔腹腔镜与传统腹腔镜全腹膜外疝修补术的前瞻性随机临床试验。

Laparoendoscopic single-site versus conventional laparoscopic total extraperitoneal hernia repair: a prospective randomized clinical trial.

机构信息

Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan,

出版信息

Surg Endosc. 2013 Dec;27(12):4684-92. doi: 10.1007/s00464-013-3116-z. Epub 2013 Aug 16.

Abstract

BACKGROUND

This study aimed to compare laparoendoscopic single-site (LESS) total extraperitoneal (TEP) repair with conventional laparoscopic TEP repair for the treatment of inguinal hernias. To date, no other studies have compared the LESS and conventional laparoscopic TEP approaches for the treatment of inguinal hernia in a prospective randomized study setting.

METHODS

For this study, 100 patients undergoing inguinal hernia repair were prospectively randomized into either the LESS TEP group or the conventional laparoscopic TEP group. Pre-, intra-, and postoperative factors were recorded. The primary end point was postoperative pain. The patients were interviewed at outpatient clinics at 1 week, 3 months, and 6 months postoperatively.

RESULTS

The demographic data were comparable between the two groups. The median operative time was longer in the LESS TEP group (63.5 min) than in the conventional TEP group (50.5 min) (p = 0.001). No conversion was performed in either group. The mean pain score 2 h postoperatively during rest was significantly higher in the conventional TEP group than in the LESS TEP group (3.9 vs. 2.6; p = 0.02). The postoperative results were comparable between the groups in terms of analgesic requirements, systemic stress responses, complications, and postoperative convalescence.

CONCLUSIONS

The LESS TEP technique is associated with a longer operative time but offers the minor benefit of a reduction in immediate postoperative pain.

摘要

背景

本研究旨在比较经脐单孔腹腔镜完全腹膜外(TEP)修补术与传统腹腔镜 TEP 修补术治疗腹股沟疝的效果。迄今为止,尚无其他研究在前瞻性随机研究中比较经脐单孔腹腔镜和传统腹腔镜 TEP 治疗腹股沟疝的效果。

方法

本研究前瞻性随机将 100 例接受腹股沟疝修补术的患者分为经脐单孔 TEP 组或传统腹腔镜 TEP 组。记录术前、术中及术后因素。主要终点为术后疼痛。患者在术后 1 周、3 个月和 6 个月时在门诊接受访谈。

结果

两组患者的人口统计学数据相似。经脐单孔 TEP 组的中位手术时间(63.5 分钟)长于传统腹腔镜 TEP 组(50.5 分钟)(p = 0.001)。两组均未进行中转。传统腹腔镜 TEP 组术后 2 小时静息时的平均疼痛评分(3.9)显著高于经脐单孔 TEP 组(2.6)(p = 0.02)。两组在镇痛需求、全身应激反应、并发症和术后恢复方面的术后结果相当。

结论

经脐单孔 TEP 技术的手术时间较长,但可明显减轻术后即刻疼痛。

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