Claus Christiano Marlo Paggi, Ruggeri João Rafael Bora, Ramos Eduardo Brommelstroet, Costa Marco Aurelio Raeder, Andriguetto Leonardo, Freitas Alexandre Coutinho Teixeira de, Coelho Júlio Cezar Uili
Minimally Invasive Surgery/Jacques Perissat Institute, Positivo University, Curitiba, PR, Brazil.
Department of Surgery, Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil.
Arq Bras Cir Dig. 2021 Oct 15;34(2):e1600. doi: 10.1590/0102-672020210002e1600. eCollection 2021.
Repair of inguinal hernia concomitant with cholecystectomy was rarely performed until more recently when laparoscopic herniorrhaphy gained more adepts. Although it is generally an attractive option for patients, simultaneous performance of both procedures has been questioned by the potential risk of complications related to mesh, mainly infection.
To evaluate a series of patients who underwent simultaneous laparoscopic inguinal hernia repair and cholecystectomy, with emphasis on the risk of complications related to the mesh, especially infection.
Fifty patients underwent simultaneous inguinal repair and cholecystectomy, both by laparoscopy, of which 46 met the inclusion criteria of this study.
In all, hernia repair was the first procedure performed. Forty-five (97,9%) were discharged within 24 h after surgery. Total mean cost of the two procedures performed separately ($2,562.45) was 43% higher than the mean cost of both operations done simultaneously ($1,785.11). Up to 30-day postoperative follow-up, seven (15.2%) presented minor complications. No patient required hospital re-admission, percutaneous drainage, antibiotic therapy or presented any other signs of mesh infection after three months. In long-term follow-up, mean of 47,1 months, 38 patients (82,6%) were revaluated. Three (7,8%) reported complications: hernia recurrence; chronic discomfort; reoperation due a non-reabsorbed seroma, one in each. However, none showed any mesh-related complication. Satisfaction questionnaire revealed that 36 (94,7%) were satisfied with the results of surgery. All of them stated that they would opt for simultaneous surgery again if necessary.
Combined laparoscopic inguinal hernia repair and cholecystectomy is a safe procedure, with no increase in mesh infection. In addition, it has important advantage of reducing hospital costs and increase patient' satisfaction.
直到最近腹腔镜疝修补术得到更多应用之前，腹股沟疝修补术与胆囊切除术同期进行的情况很少见。尽管这对患者来说通常是一个有吸引力的选择，但两种手术同时进行受到了与补片相关的潜在并发症风险（主要是感染）的质疑。
评估一系列同期接受腹腔镜腹股沟疝修补术和胆囊切除术的患者，重点关注与补片相关的并发症风险，尤其是感染风险。
50例患者通过腹腔镜同时进行腹股沟疝修补术和胆囊切除术，其中46例符合本研究的纳入标准。
总体而言，疝修补术是首先进行的手术。45例（97.9%）患者在术后24小时内出院。分别进行这两种手术的总平均费用（2562.45美元）比同时进行这两种手术的平均费用（1785.11美元）高43%。术后30天随访时，7例（15.2%）出现轻微并发症。三个月后，没有患者需要再次住院、经皮引流、抗生素治疗或出现任何其他补片感染迹象。在平均47.1个月的长期随访中，对38例（82.6%）患者进行了重新评估。3例（7.8%）报告有并发症：疝复发；慢性不适；因血清肿未吸收而再次手术，各1例。然而，均未出现任何与补片相关的并发症。满意度调查问卷显示，36例（9
