Hayakawa Shunsuke, Hayakawa Tetsushi, Inukai Koichi, Miyai Hirotaka, Yamamoto Minoru, Kitagami Hidehiko, Shimizu Yasunobu, Tanaka Moritsugu
Department of General Surgery, Kariya Toyota General Hospital, Kariya, Japan.
Department of Laparoscopic Hernia Surgery Center, Kariya Toyota General Hospital, Kariya, Japan.
Asian J Endosc Surg. 2019 Oct;12(4):396-400. doi: 10.1111/ases.12667. Epub 2018 Nov 8.
Inguinal hernia repair and cholecystectomy are frequently performed in the field of gastrointestinal surgery. However, reports describing surgical procedures that involve simultaneous transabdominal preperitoneal hernia repair (TAPP) and laparoscopic cholecystectomy (LC), as well as the safety and usefulness of this combination, are limited. Herein, we report a surgical procedure involving simultaneous TAPP and LC (TAPP + LC) and present the outcomes of patients who have undergone this combined surgical procedure, with a particular focus on its safety and usefulness.
We simultaneously performed TAPP + LC in 17 patients (mean age, 66.5 ± 8.1 years) with concomitant inguinal hernia and gallbladder stones. We assessed surgical outcomes.
The mean operative time was 157 ± 39 min, and mean postoperative hospital stay was 3.2 ± 0.6 days. The median cost was $7673 for TAPP + LC. The mean postoperative length of hospital stay was 1.1 ± 0.6 day for TAPP alone and 3.4 ± 1.4 days for LC alone. The median costs of TAPP alone and LC alone were $4932 and $5453, respectively. Regarding intraoperative complications, the inferior epigastric vessels were damaged in two patients, and seroma was detected as a postoperative complication in one; these complications were spontaneously resolved. No mesh- or infection-related complications were noted.
Simultaneous TAPP + LC is safe and can be regarded as a standard surgical procedure for patients with concomitant inguinal hernia and gallbladder stones. The TAPP + LC combination appears to help prevent the need for two hospitalizations and, thereby, reduces hospital stay and economic burden.
腹股沟疝修补术和胆囊切除术是胃肠外科领域常见的手术。然而，关于同时进行经腹腹膜前疝修补术（TAPP）和腹腔镜胆囊切除术（LC）的手术操作及其安全性和实用性的报道有限。在此，我们报告一种同时进行TAPP和LC（TAPP + LC）的手术操作，并展示接受这种联合手术患者的治疗结果，特别关注其安全性和实用性。
我们对17例（平均年龄66.5±8.1岁）合并腹股沟疝和胆囊结石的患者同时进行了TAPP + LC手术。我们评估了手术结果。
平均手术时间为157±39分钟，术后平均住院时间为3.2±0.6天。TAPP + LC的中位费用为7673美元。单纯TAPP术后平均住院时间为1.1±0.6天，单纯LC为3.4±1.4天。单纯TAPP和单纯LC的中位费用分别为4932美元和5453美元。术中并发症方面，2例患者的腹壁下血管受损，1例术后出现血清肿；这些并发症均自行缓解。未发现与补片或感染相关的并发症。
同时进行TAPP + LC是安全的，可被视为合并腹股沟疝和胆囊结石患者的标准手术操作。TAPP + LC联合手术似乎有助于避免患者需要两次住院，从而缩短住院时间并减轻经济负担。
