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使用自固定补片的腹腔镜完全腹膜外腹股沟疝修补术:235例原发性和复发性腹股沟疝的临床结果

Laparoscopic Totally Extraperitoneal Groin Hernia Repair Using a Self-Gripping Mesh: Clinical Results of 235 Primary and Recurrent Groin Hernias.

作者信息

Ozmen John, Choi Vincent, Hepburn Kirsten, Hawkins Will, Loi Ken

机构信息

St George and Kareena Private Hospitals , Sydney, New South Wales, Australia .

出版信息

J Laparoendosc Adv Surg Tech A. 2015 Nov;25(11):915-9. doi: 10.1089/lap.2015.0056. Epub 2015 Nov 2.

Abstract

INTRODUCTION

Compared with open surgery, laparoscopic groin hernia repair has been shown to significantly reduce postoperative pain. However, chronic pain remains a problem with the laparoscopic approach, affecting approximately 10% of patients. The purpose of this study was to evaluate clinical outcomes following the use of Parietex ProGrip™ (Covidien, Dublin, Ireland) self-gripping mesh during laparoscopic totally extraperitoneal groin hernia repair.

MATERIALS AND METHODS

Data were collected prospectively from 145 male and 15 female patients with 235 inguinal hernias. All patients underwent repair by the laparoscopic totally extraperitoneal approach using Parietex ProGrip mesh. During follow-up ranging from 5 to 24 months, complications, pain score, patient satisfaction, and recurrence were analyzed.

RESULTS

All patients were discharged on the day of surgery or the next morning. There were no immediate complications or returns to the operating room. Delayed postoperative complications included minor bruising to the genital region (3 cases), hematoma/seroma (1 case), and wound infection (1 case). The mean follow-up was 15 months, at which time there were no reports of hernia recurrence and 99% of patients were satisfied with their hernia repair. One patient (0.63%) reported severe pain (numeric rating scale score of >7), and 4 patients (2.5%) reported intermittent mild pain on exertion.

CONCLUSIONS

The results of this study suggest that the use of a self-gripping mesh during the laparoscopic totally extraperitoneal approach is a promising and effective technique for repairing both primary and recurrent inguinal hernias.

摘要

引言

与开放手术相比,腹腔镜腹股沟疝修补术已被证明能显著减轻术后疼痛。然而,慢性疼痛仍是腹腔镜手术方法面临的一个问题,约10%的患者受到影响。本研究的目的是评估在腹腔镜完全腹膜外腹股沟疝修补术中使用Parietex ProGrip™(柯惠医疗,都柏林,爱尔兰)自固定补片后的临床效果。

材料与方法

前瞻性收集了145例男性和15例女性患者共235例腹股沟疝的数据。所有患者均采用腹腔镜完全腹膜外入路使用Parietex ProGrip补片进行修补。在5至24个月的随访期间,分析并发症、疼痛评分、患者满意度和复发情况。

结果

所有患者均在手术当天或次日上午出院。无即刻并发症或返回手术室的情况。术后延迟并发症包括生殖器区域轻度瘀伤(3例)、血肿/血清肿(1例)和伤口感染(1例)。平均随访时间为15个月,此时无疝复发报告,99%的患者对疝修补术满意。1例患者(0.63%)报告有严重疼痛(数字评分量表得分>7),4例患者(2.5%)报告在用力时有间歇性轻度疼痛。

结论

本研究结果表明,在腹腔镜完全腹膜外入路中使用自固定补片是修复原发性和复发性腹股沟疝的一种有前景且有效的技术。

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