一项比较腹腔镜经腹腹膜前修补术（TAPP）与李金斯坦修补术治疗双侧腹股沟疝的前瞻性随机研究。
A prospective randomized study comparing laparoscopic transabdominal preperitoneal (TAPP) versus Lichtenstein repair for bilateral inguinal hernias.
机构信息
General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Spain.
General Surgery Department, Sanchinarro Hospital, San Pablo University of Madrid, Spain.
出版信息
Am J Surg. 2018 Jul;216(1):78-83. doi: 10.1016/j.amjsurg.2017.07.016. Epub 2017 Jul 19.
BACKGROUND
In literature, only a few studies have prospectively compared the results of laparoscopic with open inguinal hernia repair yet none have compared bilateral inguinal hernia repair. The aim of this study is to compare the open Lichtenstein repair (OLR) with laparoscopic trans-abdominal preperitoneal (TAPP) repair in patients undergoing surgery for bilateral inguinal hernia.
METHODS
Patients were prospectively randomized between March 2013 and March 2015. Outcome parameters included hospital stay, operation time, postoperative complications, immediate postoperative pain and chronic pain, recurrence and quality of life.
RESULTS
Sixty-one patients underwent TAPP repair and 73 underwent OLR. TAPP procedure had less early post-operative pain up to 7 days from surgery (p = 0.003), a shorter length of hospital stay (p = 0.001), less postoperative complications (p = 0.012) and less chronic pain (0.04) when compared with the OLR approach.
CONCLUSIONS
TAPP procedure for bilateral inguinal hernia effectively reduces early postoperative pain, hospital stay and postoperative complications.
背景
在文献中，只有少数研究前瞻性地比较了腹腔镜与开放式腹股沟疝修补术的结果，但没有一项研究比较了双侧腹股沟疝修补术。本研究旨在比较腹腔镜经腹腹膜前修补术（TAPP）与开放式 Lichtenstein 修补术（OLR）在双侧腹股沟疝手术患者中的疗效。
方法
患者于 2013 年 3 月至 2015 年 3 月间前瞻性随机分组。观察指标包括住院时间、手术时间、术后并发症、术后即刻疼痛和慢性疼痛、复发和生活质量。
结果
61 例患者接受了 TAPP 修补术，73 例患者接受了 OLR。TAPP 组术后早期疼痛（术后 7 天）较轻（p=0.003），住院时间较短（p=0.001），术后并发症较少（p=0.012），慢性疼痛较轻（0.04）。
结论
TAPP 术治疗双侧腹股沟疝可有效减轻术后早期疼痛、缩短住院时间、减少术后并发症。
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