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成人腹股沟疝修补术的腹腔镜经腹腹膜前技术

Laparoscopic Transabdominal Preperitoneal Technique for Inguinal Hernia Repair in Adults.

作者信息

Thanh Xuan Nguyen, Huu Son Nguyen

机构信息

Department of Abdominal Emergency and Pediatric Surgery, Hue Central Hospital, Hue, VNM.

Pediatrics, Hue Central Hospital, Hue, VNM.

出版信息

Cureus. 2020 Jun 18;12(6):e8692. doi: 10.7759/cureus.8692.

Abstract

Background Inguinal hernia repair is one of the most commonly performed operations in general surgery, especially in the digestive field. Since the introduction of laparoscopic repair as well as using a synthetic mesh, the surgical trends have changed in the last decade in treating inguinal hernias. The laparoscopic transabdominal preperitoneal gives a better view of the inguinal anatomy, and the procedure also has a short learning curve. We aim to evaluate the safety and early outcome of the laparoscopic transabdominal preperitoneal technique for inguinal hernia repair using a Prolene mesh (Ethicon Somerville, NJ, USA). Methods A prospective study was carried out among 31 adult patients with 34 inguinal hernia cases. They underwent the laparoscopic transabdominal preperitoneal technique with a Prolene mesh at the Hue Central Hospital from December 2018 through May 2019. Results The mean age was 60.4 ± 11.8, and 96.8% of cases were male. Strangulated hernia and incarcerated hernia accounted for 2.9% and 8.8% of cases, respectively. The mean duration of unilateral inguinal hernia repair and bilateral inguinal repair was 57.1 ± 17.3 minutes and 80.3 ± 10.6 minutes, respectively. The mean duration of the postoperative hospital stay was 3.9 ± 1.4 days. One (3.2%) case with contralateral inguinal hernia was detected intraoperatively. An early and three-month postoperative evaluation showed that 93.5% and 96.8% of cases were categorized as "very good", respectively. At the three-month evaluation, one case was reported with sensation disorder of the inguinal area, and there was no recurrence. Conclusions Laparoscopic transabdominal preperitoneal inguinal hernia repair is a safe and feasible technique. It allows surgeons to explore the opposite site and resolve the combined peritoneal diseases.

摘要

背景 腹股沟疝修补术是普通外科最常开展的手术之一,尤其是在消化领域。自腹腔镜修补术以及使用合成补片引入以来,过去十年间腹股沟疝的治疗手术趋势发生了变化。腹腔镜经腹腹膜前修补术能更好地观察腹股沟区解剖结构,且该手术的学习曲线较短。我们旨在评估使用普理灵补片(美国新泽西州爱思康公司)行腹腔镜经腹腹膜前技术修补腹股沟疝的安全性和早期疗效。

方法 对31例成年患者的34例腹股沟疝病例进行了一项前瞻性研究。2018年12月至2019年5月,他们在顺化中心医院接受了使用普理灵补片的腹腔镜经腹腹膜前技术治疗。

结果 平均年龄为60.4±11.8岁,96.8%的病例为男性。绞窄性疝和嵌顿性疝分别占病例的2.9%和8.8%。单侧腹股沟疝修补术和双侧腹股沟疝修补术的平均时长分别为57.1±17.3分钟和80.3±10.6分钟。术后平均住院时间为3.9±1.4天。术中发现1例(3.2%)对侧腹股沟疝。术后早期和三个月评估显示,分别有93.5%和96.8%的病例被归类为“非常好”。在三个月评估时,报告有1例腹股沟区感觉障碍,无复发情况。

结论 腹腔镜经腹腹膜前腹股沟疝修补术是一种安全可行的技术。它使外科医生能够探查对侧并解决合并的腹膜疾病。

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