Kargar S, Shiryazdi S M, Zare M, Mirshamsi M H, Ahmadi S, Neamatzadeh H
Department of Surgery, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran -
Minerva Chir. 2015 Apr;70(2):83-9. Epub 2014 Jul 14.
The aim of this randomized trial was to compare short-term postoperative complications of laparoscopic transabdominal preperitoneal (TAPP) and Lichtenstein tension free hernia repair.
A total of 120 patients who went inguinal hernia repair at Shahid Sadoughi university training hospital from April 2011 to August 2013 were randomized into two TAPP (N.=60) and Lichtenstein (N.=60) repair group. Follow-up occurred within 6 weeks. The postoperative assessments included pain score (VAS), hematoma/seroma, urinary retention, wound infection incidence, and duration of hospital stay.
Pain was the most common symptoms in both groups. The TAPP group patients significantly had experienced less postoperative pain than the Lichtenstein group in all moments (P<0.05). TAPP group had lower incidence of hematoma (TAPP, 6.6% vs. Lichtenstein 13.3%; P=0.67), seroma (TAPP 10% vs. Lichtenstein 13.3%; P=1.00), and infection (TAPP 0 vs. Lichtenstein 1.6%; P=0.67). However, no differences between the 2 groups were found in terms of postoperative complications. In TAPP group mean of hospital stay significantly was less than Lichtenstein group (TAPP, 8.13±2.19 vs. Lichtenstein, 13.15±1.5 days; P<0.001).
The laparoscopic TAPP repair is safer and less complicated approach to inguinal hernia repair. The two main short-term advantages of the laparoscopic TAPP repair with the tension free Lichtenstein repair were less postoperative pain and earlier return to the normal life activities. No difference was seen in overall complications.
本随机试验旨在比较腹腔镜经腹腹膜前修补术（TAPP）与李金斯坦无张力疝修补术的术后短期并发症。
2011年4月至2013年8月在沙希德·萨杜基大学教学医院接受腹股沟疝修补术的120例患者被随机分为两组，TAPP组（n = 60）和李金斯坦组（n = 60）。随访在6周内进行。术后评估包括疼痛评分（视觉模拟评分法）、血肿/血清肿、尿潴留、伤口感染发生率及住院时间。
疼痛是两组最常见的症状。TAPP组患者在所有时间点的术后疼痛均明显少于李金斯坦组（P < 0.05）。TAPP组血肿发生率较低（TAPP组为6.6%，李金斯坦组为13.3%；P = 0.67），血清肿发生率较低（TAPP组为10%，李金斯坦组为13.3%；P = 1.00），感染发生率较低（TAPP组为0，李金斯坦组为1.6%；P = 0.67）。然而，两组术后并发症方面未发现差异。TAPP组的平均住院时间明显少于李金斯坦组（TAPP组为8.13±2.19天，李金斯坦组为13.15±1.5天；P < 0.001）。
腹腔镜TAPP修补术是一种更安全、并发症更少的腹股沟疝修补方法。腹腔镜TAPP修补术相对于无张力李金斯坦修补术的两个主要短期优势是术后疼痛更少和能更早恢复正常生活活动。总体并发症方面未见差异。
