Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Am Surg. 2021 Apr;87(4):608-615. doi: 10.1177/0003134820949999. Epub 2020 Nov 2.
To evaluate the safety and outcomes of single-port laparoscopic totally extraperitoneal (SPLTEP) and conventional laparoscopic totally extraperitoneal (CLTEP) hernioplasty.
Retrospectively, we collected patients who underwent a laparoscopic totally extraperitoneal approach. The inclusion criteria were as follows: (1) male patients aged >20 years, (2) untreated hernia, and (3) American Society of Anesthesiologists (ASA) score ≤3. The exclusion criteria included: (1) additional procedures received during surgery, (2) inguinoscrotal hernia, (3) ASA score >3, (4) previous lower abdominal surgery, (5) bleeding disorders, and (6) incarcerated, obstructed, strangulated, or recurrent inguinal hernias. Patients were classified into SPLTEP and CLTEP groups. The demographics, body mass index (BMI), ASA score, comorbidities, blood loss, operation time, postoperative length of stay (LOS)/complications, hernia recurrence, visual analog scale (VAS), and postoperative analgesic requirements were collected for analysis.
A total of 246 patients were enrolled. There were 103 patients in the SPLTEP group and 143 patients in the CLTEP group. The mean age was 56.1 ± 16.2 years versus 57.9 ± 15.1 years. There were no significances in demographics, BMI, ASA score, comorbidities, blood loss, operation time, postoperative LOS/complications, and hernia recurrence. The SPLTEP group had a shorter postoperative LOS, lower VAS at 18 hours postoperation, and a reduced amount of 24-hour postoperative analgesics.
SPLTEP hernioplasty is as safe as the CLTEP procedure. In addition, the SPLTEP group had a shorter LOS and a lower VAS score and required less postoperative analgesics. Further studies may focus on long-term complications, hernia recurrence, and chronic pain in these 2 groups.
评估单孔腹腔镜完全腹膜外（SPLTEP）和传统腹腔镜完全腹膜外（CLTEP）疝修补术的安全性和结果。
回顾性收集接受腹腔镜完全腹膜外入路的患者。纳入标准如下：（1）男性患者年龄＞20 岁，（2）未治疗的疝，（3）美国麻醉医师协会（ASA）评分≤3。排除标准包括：（1）手术期间接受其他手术，（2）腹股沟阴囊疝，（3）ASA 评分＞3，（4）既往下腹部手术，（5）出血性疾病，（6）嵌顿、梗阻、绞窄或复发性腹股沟疝。患者分为 SPLTEP 和 CLTEP 组。收集人口统计学、体重指数（BMI）、ASA 评分、合并症、出血量、手术时间、术后住院时间（LOS）/并发症、疝复发、视觉模拟量表（VAS）和术后镇痛需求进行分析。
共纳入 246 例患者。SPLTEP 组 103 例，CLTEP 组 143 例。平均年龄 56.1±16.2 岁比 57.9±15.1 岁。人口统计学、BMI、ASA 评分、合并症、出血量、手术时间、术后 LOS/并发症和疝复发无显著差异。SPLTEP 组术后 LOS 更短，术后 18 小时 VAS 评分更低，24 小时术后镇痛药用量更少。
SPLTEP 疝修补术与 CLTEP 手术同样安全。此外，SPLTEP 组 LOS 更短，VAS 评分更低，术后需要的镇痛药更少。进一步的研究可能集中在这两组的长期并发症、疝复发和慢性疼痛上。
