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利希滕斯坦术与经腹腹膜前修补术(TAPP)治疗单侧非复发性腹股沟疝:一项关于临床结局的多中心短期随机对照研究

Lichtenstein versus transabdominal preperitoneal (TAPP) inguinal hernia repair for unilateral non recurrent hernia: A multicenter short term randomized comparative study of clinical outcomes.

作者信息

Sultan Ahmed Abd El Aal, Abo Elazm Hossam Attia, Omran Hisham

机构信息

General Surgery, Faculty of Medicine - Al-Azhar University, Egypt.

General Surgery, Faculty of Medicine - Ain Shams University, Egypt.

出版信息

Ann Med Surg (Lond). 2022 Mar 18;76:103428. doi: 10.1016/j.amsu.2022.103428. eCollection 2022 Apr.

Abstract

BACKGROUND

The repair of inguinal hernia is still one of the most prevalent surgical procedures done worldwide. Among all repair techniques, open Lichtenstein repair is the most globally conducted. In the past few decades, laparoscopic technique for inguinal hernia repair has increased technical demand. -abdominal pre-peritoneal (TAPP) technique is the main approach, which is featured by less postoperative pain and early recovery.

OBJECTIVE

The current work is a short-term study to make a comparison between open Lichtenstein repair of inguinal hernia as well as laparoscopic -abdominal preperitoneal repair of inguinal hernia (TAPP) for unilateral non recurrent hernia regarding intraoperative, postoperative complications and hospital stay.

PATIENTS AND METHODS

The present prospective randomized study recruited 100 male subjects from General Surgery Department of Al-Azhar University Hospitals and Ain Shams university hospitals suffering from oblique inguinal hernia (unilateral non recurrent hernia) with an age above 18 years and good overall health, who were randomized into two groups: Group A: 49 cases were subjected to laparoscopic -abdominal pre-peritoneal repair (TAPP). Group B: 51 cases were subjected to open Lichtenstein repair.

RESULTS

This study detected less post-operative pain day 0, day 1, day 7 and 1 month postoperatively. There was no significant difference at 6 months post-operatively.

CONCLUSION

Finally, we concluded that TAPP repair for inguinal hernia (unilateral non recurrent hernia) safer with less early post-operative pain. Also, it has fewer complications, with a significantly longer operative time.

摘要

背景

腹股沟疝修补术仍是全球最常见的外科手术之一。在所有修补技术中,开放式李金斯坦修补术是全球开展最多的。在过去几十年中,腹股沟疝修补的腹腔镜技术对技术要求有所提高。腹腔腹膜前修补术(TAPP)是主要方法,其特点是术后疼痛较轻且恢复较早。

目的

本研究是一项短期研究,旨在比较开放式李金斯坦腹股沟疝修补术与腹腔镜腹股沟疝腹腔腹膜前修补术(TAPP)治疗单侧非复发性疝的术中、术后并发症及住院时间。

患者与方法

本前瞻性随机研究从爱资哈尔大学医院和艾因夏姆斯大学医院普通外科招募了100名年龄在18岁以上、总体健康状况良好的男性斜疝(单侧非复发性疝)患者,随机分为两组:A组:49例接受腹腔镜腹腔腹膜前修补术(TAPP)。B组:51例接受开放式李金斯坦修补术。

结果

本研究发现术后第0天、第1天、第7天和1个月时术后疼痛较轻。术后6个月时无显著差异。

结论

最后,我们得出结论,腹股沟疝(单侧非复发性疝)的TAPP修补术更安全,术后早期疼痛更少。此外,其并发症更少,但手术时间明显更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90dd/8957018/adf91e46f1d6/fx1.jpg

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