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采用 TEP 治疗嵌顿性腹股沟疝对于有经验的外科医生来说是一种可行的选择。

Treating incarcerated inguinal hernias with TEP is a viable option for experienced surgeons.

机构信息

Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.

Department of Orthopaedics and Traumatology, Center of Acupuncture, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.

出版信息

Sci Rep. 2020 Nov 30;10(1):20858. doi: 10.1038/s41598-020-77925-y.

Abstract

Despite inguinal hernias being a common problem in public health, there is still scarce information about the epidemiology of the complications, especially incarceration, and their influence on the laparoscopic surgical methods considering the role of the learning process of the surgeon. Compare laparoscopic totally extraperitoneal (TEP) approach in the repair of incarcerated and non-incarcerated inguinal hernias from the perspective of technical difficulty for trained surgeons. We obtained data about sex, age, location and type of hernia, surgery duration, ASA score, postoperative complications, previous surgeries and BMI. Groups were descriptively analyzed and statistically compared to verify how similar the samples were. 265 (90.1%) patients had non-incarcerated hernias and 29 (9.9%) incarcerated. We observed that there was no significant difference in the pattern of location (right, left or bilateral), sex, ASA, previous or complications between the two groups. Unilateral incarcerated hernias had longer operative times compared to non-incarcerated. No difference was found between bilateral hernias. We didn´t find significant epidemiological differences between incarcerated and non-incarcerated hernias. In our experience, with the limitation of a single-surgeon series, laparoscopic hernia repair achieved satisfactory results in terms of feasibility (especially for bilateral hernias) and safety.

摘要

尽管腹股沟疝在公共卫生中是一个常见问题,但关于并发症的流行病学,特别是嵌顿的信息仍然很少,考虑到外科医生学习过程的作用,其对腹腔镜手术方法的影响也知之甚少。比较腹腔镜完全腹膜外(TEP)方法在修复嵌顿和非嵌顿腹股沟疝中的技术难度,从经过训练的外科医生的角度来看。我们获得了有关性别、年龄、疝的位置和类型、手术持续时间、ASA 评分、术后并发症、先前手术和 BMI 的数据。对两组进行描述性分析和统计学比较,以验证样本的相似性。265 例(90.1%)患者为非嵌顿疝,29 例(9.9%)为嵌顿疝。我们观察到两组在位置(右侧、左侧或双侧)、性别、ASA、先前手术或并发症方面无显著差异。单侧嵌顿疝的手术时间明显长于非嵌顿疝。双侧疝之间无差异。我们没有发现嵌顿疝和非嵌顿疝之间存在显著的流行病学差异。在我们的经验中,在单外科医生系列的限制下,腹腔镜疝修补术在可行性方面(特别是双侧疝)和安全性方面取得了令人满意的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c464/7705708/ea89b8b3d842/41598_2020_77925_Fig1_HTML.jpg

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