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腹膜前间隙球囊与腔镜解剖在完全腹膜外疝修补术中的比较。我们的初步经验!

The Comparison of Balloon and Camera Dissection of the Preperitoneal Space in Totally Extraperitoneal Repair Hernia Repair. Our Initial Experience!

机构信息

General Surgeon, Yeni Yuzyıl University, Istanbul, Turkey.

出版信息

Surg Innov. 2021 Dec;28(6):695-699. doi: 10.1177/1553350621999297. Epub 2021 Mar 12.

Abstract

. To perform totally extraperitoneal repair of a hernia, it is essential to create a working space for the placement of instruments. In this study, we aimed to compare balloon dissection (BD) and camera or telescopic dissection (CD) with respect to the surgical outcomes, without considering the cost-effectiveness. . Forty consecutive, healthy, unilateral inguinal hernia patients who underwent Totally Extraperitoneal Repair hernia repair were randomized into 2 groups according to whether they received BD or CD. The perioperative demographic characteristics were recorded. All the operations were video recorded from the beginning to the end of each procedure. The virtually constructed periods of the procedures were evaluated by another surgeon who watched each video. The time spent for each period, the severity score assigned by the surgeon, the total operation time, the peritoneal laceration rate, the presence of early and late postoperative pain, the number of postoperative visits, the total analgesic requirements, and the complications were recorded. . The demographic properties of the patients, the perioperative and postoperative complications, and the severity scores in the BD and CD groups were statistically similar. The total operating time and the time from the dissection of the peritoneum to the reduction of the hernia sac were significantly longer in the CD group. Post-discharge analgesic consumption, Visual Analog Scale scores, and the number of visits were similar between the groups. . The dissection of the working space in the preperitoneal area can be achieved using camera dissection without the risk of common complications associated with balloon dissection, particularly balloon rupture.

摘要

. 为了进行完全腹膜外疝修补术,创建一个用于放置器械的工作空间至关重要。在本研究中,我们旨在比较球囊解剖(BD)和摄像或望远镜解剖(CD)在手术结果方面的差异,而不考虑成本效益。. 40 例连续的、健康的单侧腹股沟疝患者,根据是否接受 BD 或 CD 治疗,随机分为 2 组,行完全腹膜外疝修补术。记录围手术期人口统计学特征。所有手术均从手术开始到结束进行视频记录。另一名外科医生观看每个视频,评估虚拟构建手术各阶段的时间。记录每个阶段的时间、外科医生分配的严重程度评分、总手术时间、腹膜撕裂率、早期和晚期术后疼痛的发生、术后就诊次数、总镇痛需求以及并发症。. BD 和 CD 组患者的人口统计学特征、围手术期和术后并发症以及严重程度评分均无统计学差异。CD 组的总手术时间和从切开腹膜到疝囊复位的时间明显更长。出院后镇痛消耗、视觉模拟评分和就诊次数在两组之间相似。. 在腹膜前区域,使用摄像解剖可以实现工作空间的解剖,而不会有与球囊解剖相关的常见并发症的风险,特别是球囊破裂。

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