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经完全腹膜外途径的视频内镜下无张力腹股沟疝修补术

Video-endoscopic Tension-free Groin Hernia Repair via Total Extraperitoneal Approach.

作者信息

Dogan Sami, Gurleyik Emin

机构信息

Surgery, Duzce University Medical Faculty, Düzce, TUR.

出版信息

Cureus. 2020 Feb 1;12(2):e6839. doi: 10.7759/cureus.6839.

Abstract

Introduction Tension-free repair of groin hernias with synthetic material by video-endoscopic surgery is a widely accepted method that is performed by various approaches. We aim to present our results of video-endoscopic tension-free repair of groin hernias via the total extraperitoneal (TEP) approach. Methods Between September 2016 and December 2018, 124 patients with groin hernias underwent tension-free repair using prolene mesh by video-endoscopic surgery via the TEP approach. This is a retrospective analysis of 110 (88.7%) male and 14 (11.3%) female patients with a mean age of 48.1 years. Groin hernia types, locations of hernias, intraoperative and postoperative complications, results of the mean 24-month follow-up, and recurrence rate were reported. Results A total of 134 hernias were repaired in 124 patients who had 53 (42.7%) right, 61 (49.2%) left, and 10 (8.1%) bilateral groin hernias. The most common hernia type was an indirect inguinal hernia in 83/134 (62%) groin hernias. A total of 119 (88.8%) and 15 (11.2%) hernias were primary and recurrent, respectively. Seroma was detected in two (1.6%) patients in the early postoperative period. The mean duration of hospital stay was 1.4 (1-3) days. During the follow-up period, hernia recurrence was determined in three (2.4%) patients. Hernia recurrence was detected among patients who were operated on during the first half of the study. Conclusion Tension-free repair of groin hernias by video-endoscopic technique via the TEP approach can be performed with very low complication and recurrence rates. The success of the TEP approach increases parallel to increasing surgical experience. The results of hernia repair via the TEP approach are highly satisfactory and encouraging, especially when attention is paid to proper patient selection during the learning curve period.

摘要

引言 采用合成材料通过视频内镜手术对腹股沟疝进行无张力修补是一种被广泛接受的方法,可通过多种入路实施。我们旨在展示经完全腹膜外(TEP)入路进行视频内镜下腹股沟疝无张力修补的结果。

方法 2016年9月至2018年12月期间,124例腹股沟疝患者通过TEP入路经视频内镜手术使用普理灵补片进行无张力修补。这是一项对110例(88.7%)男性和14例(11.3%)女性患者的回顾性分析,平均年龄为48.1岁。报告了腹股沟疝类型、疝的位置、术中及术后并发症、平均24个月随访结果以及复发率。

结果 124例患者共修补了134处疝,其中右侧53处(42.7%)、左侧61处(49.2%)、双侧10处(8.1%)腹股沟疝。最常见的疝类型是83/134(62%)例腹股沟疝为腹股沟斜疝。分别有119处(88.8%)和15处(11.2%)疝为原发性和复发性。术后早期在2例(1.6%)患者中发现血清肿。平均住院时间为1.4(1 - 3)天。随访期间,3例(2.4%)患者出现疝复发。在研究上半年接受手术的患者中检测到疝复发。

结论 通过TEP入路采用视频内镜技术对腹股沟疝进行无张力修补,并发症和复发率极低。TEP入路的成功率随着手术经验的增加而提高。经TEP入路进行疝修补的结果非常令人满意且鼓舞人心,尤其是在学习曲线阶段注意正确选择患者时。

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