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内镜下全腹膜外(TEP)修补腹股沟区损伤(运动员疝):一项前瞻性观察性队列研究(TEP-ID研究)的原理与设计

Endoscopic totally extraperitoneal (TEP) hernia repair for inguinal disruption (Sportsman's hernia): rationale and design of a prospective observational cohort study (TEP-ID-study).

作者信息

Voorbrood C E H, Goedhart E, Verleisdonk E J M M, Sanders F, Naafs D, Burgmans J P J

机构信息

Department of Surgery, Diakonessenhuis, Utrecht/Zeist, Zeist, The Netherlands.

KNVB/FIFA Medical Centre of Excellence (Sport Medical Centre of the Royal Netherlands Football Association/FIFA Medical Centre of Excellence), Zeist, The Netherlands.

出版信息

BMJ Open. 2016 Jan 6;6(1):e010014. doi: 10.1136/bmjopen-2015-010014.

Abstract

INTRODUCTION

Chronic inguinal pain is a frequently occurring problem in athletes. A diagnosis of inguinal disruption is performed by exclusion of other conditions causing groin pain. Up to now, conservative medical management is considered to be the primary treatment for this condition. Relevant large and prospective clinical studies regarding the treatment of inguinal disruption are limited; however, recent studies have shown the benefits of the totally extraperitoneal patch (TEP) technique.This study provides a complete assessment of the inguinal area in athletes with chronic inguinal pain before and after treatment with the TEP hernia repair technique.

METHODS AND ANALYSIS

We describe the rationale and design of an observational cohort study for surgical treatment with the endoscopic TEP hernia repair technique in athletes with a painful groin (inguinal disruption).The study is being conducted in a high-volume, single centre hospital with specialty in TEP hernia repair. Patients over 18 years, suffering from inguinal pain for at least 3 months during or after playing sports, and whom have not undergone previous inguinal surgery and have received no benefit from physiotherapy are eligible for inclusion. Patients with any another cause of inguinal pain, proven by physical examination, inguinal ultrasound, X-pelvis/hip or MRI are excluded.Primary outcome is reduction in pain after 3 months. Secondary outcomes are pain reduction, physical functioning, and resumption of sport (in frequency and intensity).

ETHICS AND DISSEMINATION

An unrestricted research grant for general study purposes was assigned to the Hernia Centre. This study itself is not directly subject to the above mentioned research grant or any other financial sponsorship. We intend to publish the outcome of the study, regardless of the findings. All authors will give final approval of the manuscript version to be published.

摘要

引言

慢性腹股沟疼痛是运动员中常见的问题。腹股沟损伤的诊断是通过排除其他导致腹股沟疼痛的病症来进行的。到目前为止,保守药物治疗被认为是这种病症的主要治疗方法。关于腹股沟损伤治疗的相关大型前瞻性临床研究有限;然而,最近的研究显示了完全腹膜外补片(TEP)技术的益处。本研究对采用TEP疝修补技术治疗前后的慢性腹股沟疼痛运动员的腹股沟区域进行了全面评估。

方法与分析

我们描述了一项观察性队列研究的基本原理和设计,该研究针对患有腹股沟疼痛(腹股沟损伤)的运动员采用内镜TEP疝修补技术进行手术治疗。该研究在一家擅长TEP疝修补的高容量单中心医院进行。年龄超过18岁、在运动期间或运动后患有腹股沟疼痛至少3个月、之前未接受过腹股沟手术且物理治疗无效果的患者符合纳入标准。通过体格检查、腹股沟超声、X线骨盆/髋关节或磁共振成像证实有任何其他导致腹股沟疼痛原因的患者被排除。主要结局是3个月后疼痛减轻。次要结局是疼痛减轻、身体功能以及运动恢复(频率和强度)。

伦理与传播

疝中心获得了一笔用于一般研究目的的无限制研究资助。本研究本身并不直接受上述研究资助或任何其他资金赞助的约束。无论研究结果如何,我们都打算发表该研究的结果。所有作者将对拟发表的稿件版本给予最终批准。

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Surgical treatment of chronic groin pain in athletes.运动员慢性腹股沟疼痛的手术治疗。
Int Orthop. 2012 Nov;36(11):2361-5. doi: 10.1007/s00264-012-1632-4. Epub 2012 Aug 10.

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