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前列腺癌根治术后患者经腹腹膜前腹腔镜腹股沟疝修补术的结果及并发症评估

Evaluation of the Results and Complications of Transabdominal Preperitoneal Laparoscopic Inguinal Hernia Repair in Patients with a History of Radical Prostatectomy.

作者信息

Izadpanahi Mohammad Hossein, Milasi Rana

机构信息

Isfahan Kidney Transplantation Research Center, Department of Urology, Alzahra Research Centers, Isfahan University of Medical Sciences, Isfahan, Iran.

Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

Urol J. 2020 Jan 26;17(1):24-29. doi: 10.22037/uj.v0i0.4751.

Abstract

PURPOSE

Radical prostatectomy is one of the most common urological surgeries. Inguinal hernia is a well-known complication of radical prostatectomy. There are many controversies about selection of surgical techniques for repair of inguinal hernia. Traditionally laparoscopic approach was contraindicated for patients with history of lower abdominal surgery, but recent studies showed that it could be safe and successful and even has some advantages over open repair. In this prospective study we evaluated outcomes of laparoscopic hernia repair in patients who previously underwent radical prostatectomy.

MATERIALS AND METHODS

In this prospective study, 34 consecutive patients diagnosed with inguinal hernia after radical retropubic prostatectomy underwent laparoscopic transabdominal inguinal repair and followed up for outcomes and complications.

RESULTS

The surgery duration was 167.44 ± 52.85 min (75-230 min). No intraoperative complications occurred. Patients were discharged within 20.79 ± 4.76 hours (12-34 hours). 69.8% of cases (30 patients) needed analgesic administration. No conversion to open surgery occurred. There were 9.3% (4 hernias) hernia recurrences. We followed patients for 9.9 ± 5.33 months (2-19 months).

CONCLUSION

It is concluded that TAPP for inguinal hernia repair after radical prostatectomy has good results and is effective. But according to rate of recurrence, its safeness is conflicting. We notice no major complication in our patients during the time of follow up. This may be due to safety of the operation in the proposed patients.

摘要

目的

根治性前列腺切除术是最常见的泌尿外科手术之一。腹股沟疝是根治性前列腺切除术的一种常见并发症。对于腹股沟疝修补手术技术的选择存在诸多争议。传统上,有下腹部手术史的患者禁忌采用腹腔镜手术方式,但近期研究表明,该手术方式可能安全且成功,甚至相较于开放修补术具有某些优势。在这项前瞻性研究中,我们评估了既往接受过根治性前列腺切除术的患者行腹腔镜疝修补术的疗效。

材料与方法

在这项前瞻性研究中,34例在耻骨后根治性前列腺切除术后被诊断为腹股沟疝的连续患者接受了腹腔镜经腹腹股沟修补术,并对其疗效及并发症进行了随访。

结果

手术时长为167.44 ± 52.85分钟(75 - 230分钟)。术中未发生并发症。患者在20.79 ± 4.76小时(12 - 34小时)内出院。69.8%的病例(30例患者)需要使用镇痛药。未发生转为开放手术的情况。疝复发率为9.3%(4例疝)。我们对患者进行了9.9 ± 5.33个月(2 - 19个月)的随访。

结论

得出结论,根治性前列腺切除术后行腹腔镜经腹腹膜前疝修补术效果良好且有效。但根据复发率来看,其安全性存在争议。在随访期间,我们的患者未出现重大并发症。这可能是由于该手术方式对所纳入患者的安全性较高。

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