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单孔腹腔镜腹股沟疝修补术与传统腹腔镜腹股沟疝修补术的比较

Single-Incision Laparoscopic Inguinal Hernioplasty Versus Conventional Laparoscopic Inguinal Hernioplasty.

作者信息

Luo Shanshan, Wu Shike, Lai Hao, Mo Xianwei, Chen Jiansi

机构信息

1 Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi Autonomous Region, China.

出版信息

Surg Innov. 2017 Apr;24(2):171-182. doi: 10.1177/1553350617690308. Epub 2017 Feb 5.

Abstract

PURPOSE

Additional studies comparing single-incision laparoscopic inguinal hernioplasty (SILH) and conventional laparoscopic inguinal hernioplasty (CLH) have been published, and this study updates the meta-analysis of this subject.

METHODS

Two reviewers independently searched the PubMed, Embase, Google Scholar, and Cochrane Library electronic databases to locate original articles that compared SILH and CLH for inguinal hernia that were published until October 2015. Operative time, conversions, complications, length of hospital stay, recurrence, postoperative pain at 24 hours, and postoperative pain at 7 days were compared using Stata software, version 12.0.

RESULTS

Sixteen studies were selected for this analysis, which included a total of 1672 patients (907 in SILH and 765 in CLH). SILH showed a longer operative time; however, conversions, complications, length of hospital stay, recurrence, postoperative pain at 24 hours, and postoperative pain at 7 days were similar between the 2 groups.

CONCLUSIONS

Our meta-analysis has shown that inguinal hernia repair using SILH is as safe as CLH. However, based on our evidence, we currently believe that SILH is not an efficacious surgical alternative to CLH for inguinal hernias due to the fact that it does not provide significant benefit in postoperative pain and cosmetic outcomes. However, large-scale, well-designed, and multicenter studies will be needed to further confirm the results of this study.

摘要

目的

已有更多比较单切口腹腔镜腹股沟疝修补术(SILH)和传统腹腔镜腹股沟疝修补术(CLH)的研究发表,本研究对该主题的荟萃分析进行了更新。

方法

两名研究者独立检索了PubMed、Embase、谷歌学术和考克兰图书馆电子数据库,以查找截至2015年10月发表的比较SILH和CLH治疗腹股沟疝的原始文章。使用Stata软件12.0版比较手术时间、中转率、并发症、住院时间、复发率、术后24小时疼痛和术后7天疼痛情况。

结果

本分析选取了16项研究,共纳入1672例患者(SILH组907例,CLH组765例)。SILH组手术时间较长;然而,两组之间的中转率、并发症、住院时间、复发率、术后24小时疼痛和术后7天疼痛情况相似。

结论

我们的荟萃分析表明,使用SILH进行腹股沟疝修补与CLH一样安全。然而,基于现有证据,我们目前认为,由于SILH在术后疼痛和美容效果方面未提供显著益处,因此它并非CLH治疗腹股沟疝的有效手术替代方法。然而,需要大规模、设计良好的多中心研究来进一步证实本研究结果。

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