Atmaca Ali Fuat, Hamidi Nurullah, Canda Abdullah Erdem, Keske Murat, Ardicoglu Arslan
1Department of Urology, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara Atatürk Training and Research Hospital, Cankaya, Ankara 06430, Turkey.
Department of Urology, Koc University School of Medicine, Maltepe, Istanbul 34010, Turkey.
Urol J. 2018 Nov 17;15(6):381-386. doi: 10.22037/uj.v0i0.4158.
To assessment the safety of concurrent repair of inguinal hernia (IH) with mesh application during transperitoneal robotic-assisted radical prostatectomy(RARP).
Data of 20 patients (totally 25 procedures) who performed concurrent IH repair with mesh application during RARP were retrospectively enrolled in this study. Preoperative patient characteristics, intra and postoperative parameters (pathological Gleason grade, prostate volume at surgical specimen, operative time, herniorrhaphy time, estimated blood loss, complications, time of hospitalization, catheterization, and drainage) were evaluated. Standard PSA control and postoperative complications of mesh application such as herniarecurrence, mesh infection, seroma formation and groin pain were evaluated at every follow-up visits (every three in the first year, then every 6 months in years 2 to 5 and annually thereafter.
The mean age was 66 ± 8 years in our population. Fifteen (60 %) patients had a unilateral hernia and 5 (40%) patients had bilateral hernias. The mean operative time was 139 ± 21minutes and estimated mean blood loss was 108 ± 76 mL. The mean duration of IH repair in patients which was 27 ± 5 (range: 17- 40) minutes. The mean time of drainage, hospitalization, and catheterization were 2.5 ± 0.8 days (range: 2-6), 4 ± 0.9 days (range: 2-7) and 8.2 ± 1.9 days (range: 7-14), respectively. We did not observe any intra-operative complication due to RARP orIH repair. Wound evisceration at camera port site developed in only a patient on postoperative day 20. Our median follow-up time was 13 months and we did not observe mesh infection or hernia recurrence during follow-up.
Concurrent IH repair with RARP procedure seem to be easy to perform, effective and safe procedure.
评估经腹腔机器人辅助根治性前列腺切除术(RARP)期间应用补片同时修复腹股沟疝(IH)的安全性。
本研究回顾性纳入了20例患者(共25例手术),这些患者在RARP期间应用补片同时进行IH修复。评估术前患者特征、术中和术后参数(病理Gleason分级、手术标本的前列腺体积、手术时间、疝修补时间、估计失血量、并发症、住院时间、导尿时间和引流时间)。在每次随访时(第1年每3个月一次,第2至5年每6个月一次,此后每年一次)评估标准PSA控制情况以及补片应用的术后并发症,如疝复发、补片感染、血清肿形成和腹股沟疼痛。
我们研究人群的平均年龄为66±8岁。15例(60%)患者为单侧疝,5例(40%)患者为双侧疝。平均手术时间为139±21分钟,估计平均失血量为108±76毫升。患者IH修复的平均持续时间为27±5(范围:17 - 40)分钟。引流、住院和导尿的平均时间分别为2.5±0.8天(范围:2 - 6)、4±0.9天(范围:2 - 7)和8.2±1.9天(范围:7 - 14)。我们未观察到因RARP或IH修复导致的任何术中并发症。仅1例患者在术后第20天出现摄像头端口部位伤口脏器脱出。我们的中位随访时间为13个月,随访期间未观察到补片感染或疝复发。
RARP手术同时进行IH修复似乎是一种易于实施、有效且安全的手术。