Cawich Shamir O, Mohanty Sanjib K, Bonadie Kimon O, Simpson Lindberg K, Johnson Peter B, Shah Sundeep, Williams Eric W
Department of Surgery, University of the West Indies, Mona, Kingston 7, Jamaica, West Indies.
Department of Surgery, Cayman Islands Hospital, Grand Cayman, British West Indies.
J Surg Tech Case Rep. 2013 Jan;5(1):13-7. doi: 10.4103/2006-8808.118601.
There are no published data on the outcomes of inguinal hernia repair from the Anglophone Caribbean. To the best of our knowledge, this is the first report of a series of laparoscopic inguinal hernia repairs from the region.
Data was extracted from a prospectively maintained database of consecutive trans abdominal pre-peritoneal (TAPP) repairs done between June 1, 2005 and May 30, 2012. Perioperative data collected included patient demographics, hernia type, operative technique, duration of surgery, intra-operative details, morbidity, analgesia requirements, and duration of hospitalization. A telephone survey was also performed to identify late recurrences and complications. Descriptive statistics were generated using Statistical Package for Social Sciences (SPSS) Ver 12.0.
There were 103 consecutive TAPP procedures in 88 patients at an average age of 35.4 years ± 12.9 (standard deviation; SD) and average body mass index (BMI) of 28.9 Kg/m(2) ± 2.23 (SD). The indications were bilateral (30), recurrent unilateral (24), and primary unilateral (49) inguinal hernias. The mean duration of operation was 68.5 minutes (SD ± 10.4; Range: 55-95; Median 65; Mode 65) minutes for unilateral TAPP and 89 minutes (SD ± 7.61; Range: 80-105; Median 90; Mode 90) for bilateral repairs. Post-operatively, 65/70 patients required ≤1 dose of parenteral opioid analgesia and 74 (84.1%) patients discontinued oral analgesia within 48 hours of operation. Complications were recorded in six (5.8%) cases and a recurrence in one (0.97%) case after a mean follow-up period of 3.2 years (SD ± 1.8; Range: 0.5-7).
Laparoscopic inguinal hernia repair is a safe and effective operation in this setting.
来自英语加勒比地区的腹股沟疝修补术的结果尚无公开数据。据我们所知,这是该地区一系列腹腔镜腹股沟疝修补术的首次报告。
数据取自2005年6月1日至2012年5月30日期间前瞻性维护的连续经腹腹膜前(TAPP)修补术数据库。收集的围手术期数据包括患者人口统计学资料、疝类型、手术技术、手术时间、术中细节、发病率、镇痛需求和住院时间。还进行了电话调查以确定晚期复发和并发症情况。使用社会科学统计软件包(SPSS)12.0版进行描述性统计分析。
88例患者连续接受了103例TAPP手术,平均年龄为35.4岁±12.9(标准差;SD),平均体重指数(BMI)为28.9 Kg/m²±2.23(SD)。手术指征为双侧腹股沟疝(30例)、复发性单侧腹股沟疝(24例)和原发性单侧腹股沟疝(49例)。单侧TAPP手术的平均时长为68.5分钟(SD±10.4;范围:55 - 95;中位数65;众数65),双侧修补手术的平均时长为89分钟(SD±7.61;范围:80 - 105;中位数90;众数90)。术后,65/70例患者需要≤1剂胃肠外阿片类镇痛剂,74例(84.1%)患者在术后48小时内停止口服镇痛。平均随访3.2年(SD±1.8;范围:0.5 - 7)后,6例(5.8%)出现并发症,1例(0.97%)复发。
在这种情况下,腹腔镜腹股沟疝修补术是一种安全有效的手术。