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开放腹膜前修补术与经腹腹膜前疝修补术治疗原发性单侧股疝的比较:一项对132例病例的回顾性队列研究

Comparison of open preperitoneal and transabdominal preperitoneal hernia repair for primary unilateral femoral hernia: a retrospective cohort study of 132 case.

作者信息

Liu Jing, Bittner Reinhard, Shen Yingmo, Chen Jie

机构信息

Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang, Beijing, 100020, China.

Director of the Surgical Clinic, Marienhospital Stuttgart, Supperstr. 19, 70565, Stuttgart, Germany.

出版信息

Surg Endosc. 2023 Apr;37(4):2712-2718. doi: 10.1007/s00464-022-09759-w. Epub 2022 Nov 30.

Abstract

BACKGROUND

Femoral hernia (FH) is traditionally treated by open surgery (OS). Laparoscopic treatment has also shown good results in treating FH. However, there have been few comparative studies of these two techniques. Therefore, our aim was to compare the outcomes of open and laparoscopic surgical FH treatment.

METHODS

Adult patients with primary unilateral FH undergoing OS or transabdominal preperitoneal (TAPP) hernia repair at our hospital from January 2013 to June 2018 were included in this study. Patients with history of abdominal surgery, contraindications to general anesthesia and those not wishing to receive general anesthesia received OS. Demographics, operation details and complications were compared retrospectively between the two groups.

RESULTS

A total of 132 patients were recruited to the study, 62 and 70 of whom underwent OS and TAPP, respectively. Compared to OS group, the TAPP group had a significantly shorter hospital stay (3.0 vs. 2.0 days, respectively, P < 0.05) and a lower postoperative pain score (3.0 vs. 1.0, P < 0.05), and took less time to return to normal activities (13.0 vs. 6.0 days, respectively, P < 0.05). The overall complication rates were equivalent between the groups (10 vs. 9.7%, OR = 1.037, 95% CI 0.329-3.270).

CONCLUSIONS

Both laparoscopic and open surgery appear to be safe and effective in a cohort of patients with femoral hernia and laparoscopic surgery might offer some advantages in reducing length of hospital stay, lower postoperative pain score and quicker return to activities.

摘要

背景

股疝(FH)传统上通过开放手术(OS)治疗。腹腔镜治疗在股疝治疗中也显示出良好效果。然而,这两种技术的比较研究较少。因此,我们的目的是比较开放手术和腹腔镜手术治疗股疝的结果。

方法

纳入2013年1月至2018年6月在我院接受开放手术或经腹腹膜前(TAPP)疝修补术的成年原发性单侧股疝患者。有腹部手术史、全身麻醉禁忌证以及不愿接受全身麻醉的患者接受开放手术。对两组患者的人口统计学、手术细节和并发症进行回顾性比较。

结果

共132例患者纳入本研究,其中62例和70例分别接受了开放手术和TAPP手术。与开放手术组相比,TAPP组住院时间显著缩短(分别为3.0天和2.0天,P<0.05),术后疼痛评分更低(3.0和1.0,P<0.05),恢复正常活动所需时间更短(分别为13.0天和6.0天,P<0.05)。两组总体并发症发生率相当(10%对9.7%,OR = 1.037,95%CI 0.329 - 3.270)。

结论

对于股疝患者群体,腹腔镜手术和开放手术似乎都是安全有效的,腹腔镜手术在缩短住院时间、降低术后疼痛评分和更快恢复活动方面可能具有一些优势。

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