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完全腹膜外疝修补术与平片无张力疝修补术治疗腹股沟疝的早期术后效果比较:一项前瞻性随机研究。

Comparison of Early Postoperative Outcomes Between Totally Extraperitoneal and Lichtenstein Repair of Inguinal Hernia: A Prospective Randomized Study.

机构信息

Department of General Surgery, Elazig Fethi Sekin City Hospital, Elazig, Turkey.

Department of General Surgery, Uskudar University Faculty of Medicine, Memorial Hospital, Istanbul, Turkey.

出版信息

J Laparoendosc Adv Surg Tech A. 2023 Nov;33(11):1025-1032. doi: 10.1089/lap.2023.0199. Epub 2023 Aug 3.

Abstract

Surgical repair of inguinal hernia is among the most commonly performed surgical interventions in general surgery clinics, with minimal postoperative complications, less pain, and maximum cosmetic results. The aim of this study is to compare the outcomes of patients who underwent Lichtenstein repair (LR), which is currently the most commonly used open surgical procedure to repair inguinal hernias, and laparoscopic totally extraperitoneal (TEP) repair with regard to postoperative cosmesis, patient satisfaction, pain, and inflammatory response. The study consisted of male patients 18-65 years of age, who were operated for inguinal hernia with two different methods between February 2022 and January 2023 in the general surgery clinic of Elazig Fethi Sekin City Hospital. C-reactive protein (CRP), white blood cell, and interleukin 6 (IL-6) levels were observed to evaluate the inflammatory response in all patients. Visual Analog Scale and Verbal Rating Score systems were used to monitor the response to pain in the postoperative period. In addition, both groups were evaluated for patient satisfaction in cosmetic terms using the Vancouver Scar Scale and the Modified Stony Brook Scar Evaluation Scale. Postoperative pain sensation in the TEP group was found to be significantly lower compared to the LR group. In terms of inflammatory response, IL-6 and CRP levels were found to be significantly higher in the LR group on postoperative day 1 and 2. Satisfaction with the cosmetic appearance of the surgical scar was significantly higher in the TEP group. TEP, which is a laparoscopic hernia repair method, is a safe surgical technique that can be preferred, especially in patients with less postoperative pain and higher cosmetic expectations. In terms of inflammatory response, significant difference is also in favor of TEP repair.

摘要

腹股沟疝的手术修复是普通外科诊所最常进行的手术干预之一,具有术后并发症少、疼痛轻和美容效果最佳的特点。本研究旨在比较目前最常用于修复腹股沟疝的开放式手术 Lichtenstein 修复(LR)和腹腔镜完全腹膜外(TEP)修复的患者的术后美容效果、患者满意度、疼痛和炎症反应。该研究纳入了 2022 年 2 月至 2023 年 1 月期间在 Elazig Fethi Sekin 市医院普通外科诊所接受两种不同方法治疗腹股沟疝的 18-65 岁男性患者。观察所有患者的 C 反应蛋白(CRP)、白细胞和白细胞介素 6(IL-6)水平,以评估炎症反应。使用视觉模拟量表和口头评分量表系统监测术后疼痛反应。此外,使用温哥华瘢痕量表和改良 Stony Brook 瘢痕评估量表评估两组患者的美容满意度。TEP 组术后疼痛感觉明显低于 LR 组。在炎症反应方面,LR 组术后第 1 天和第 2 天的 IL-6 和 CRP 水平明显升高。TEP 组对手术瘢痕美容外观的满意度明显更高。TEP 是一种腹腔镜疝修补方法,是一种安全的手术技术,特别是对于术后疼痛较轻和美容期望较高的患者,可以优先选择。在炎症反应方面,TEP 修复也具有显著优势。

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