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腹腔镜经腹腹膜前修补术与完全腹膜外修补术治疗腹股沟疝:两种技术术中及术后早期并发症的比较

Laparoscopic transabdominal preperitoneal and totally extraperitoneal in inguinal hernia surgery: comparison of intraoperative and postoperative early complications of two techniques.

作者信息

Yildiz Abdullah

机构信息

Department of General Surgery, University of Health Sciences Ümraniye Training and Research Hospital, Istanbul, Turkey.

出版信息

J Minim Invasive Surg. 2022 Mar 15;25(1):18-23. doi: 10.7602/jmis.2022.25.1.18.

Abstract

PURPOSE

Totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) are laparoscopic techniques frequently used in inguinal hernia surgeries. There are very few studies directly comparing the outcomes of TEP and TAPP. The present study compared both techniques' technical aspects, intraoperative and postoperative early complications.

METHODS

In this study, 108 patients diagnosed with inguinal hernia underwent laparoscopic surgery between May 2016 and December 2020. Seventy six of these patients (70.4%) underwent TEP, and 32 (29.6%) underwent TAPP. This study was retrospective. However, the data were registered prospectively (including video recordings).

RESULTS

No significant difference was found between the groups regarding age, sex, body mass index, American Society of Anesthesiologist physical status classification, and duration of hospitalization. Although the TEP group had a higher overall complication rate than TAPP, the difference between the two groups was not significant (TEP, 9.2% vs. TAPP, 3.1%, = 0.979). Two conversions and two recurrences (2.6% each) were observed in TEP. The hematoma was seen in one case in both techniques (3.1% vs. 1.3%, = 0.665), respectively. A patient in the TEP group developed a pseudoaneurysm and was treated with endovascular embolization.

CONCLUSION

In our study, conversion and intraoperative early postoperative complications were more prevalent in TEP than TAPP. On the other hand, no significant difference was determined between the results of the two techniques. It has been found that TAPP is as safe as TEP in inguinal hernia surgery; however, the superiority of one method over the other was not observed in this study.

摘要

目的

完全腹膜外(TEP)和经腹腹膜前(TAPP)是腹股沟疝手术中常用的腹腔镜技术。直接比较TEP和TAPP手术效果的研究非常少。本研究比较了这两种技术的技术层面、术中及术后早期并发症。

方法

本研究中,108例诊断为腹股沟疝的患者在2016年5月至2020年12月期间接受了腹腔镜手术。其中76例患者(70.4%)接受了TEP手术,32例(29.6%)接受了TAPP手术。本研究为回顾性研究。然而,数据是前瞻性记录的(包括视频记录)。

结果

两组在年龄、性别、体重指数、美国麻醉医师协会身体状况分级和住院时间方面无显著差异。虽然TEP组的总体并发症发生率高于TAPP组,但两组之间的差异不显著(TEP组为9.2%,TAPP组为3.1%,P = 0.979)。TEP组观察到2例中转手术和2例复发(各占2.6%)。两种技术各有1例出现血肿(分别为3.1%和1.3%,P = 0.665)。TEP组有1例患者发生假性动脉瘤,接受了血管内栓塞治疗。

结论

在我们的研究中,TEP组的中转手术及术中术后早期并发症比TAPP组更常见。另一方面,两种技术的结果之间未发现显著差异。已发现TAPP在腹股沟疝手术中与TEP一样安全;然而,本研究未观察到一种方法优于另一种方法。

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