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腹腔镜经腹腹膜前修补术治疗女性腹股沟疝。

Laparoscopic transabdominal preperitoneal repair for female patients with groin hernias.

机构信息

Department of General surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.

出版信息

BMC Womens Health. 2023 Aug 9;23(1):422. doi: 10.1186/s12905-023-02527-5.

Abstract

BACKGROUND

Laparoscopic transabdominal preperitoneal repair (TAPP) was recommended for female patients with groin hernias. Whereas, only a few studies focused on whether and how to preserve the round ligament of the uterus in TAPP.

METHODS

Clinical data of 159 female patients with 181 groin hernias who underwent TAPP at a single institution in China from January 2016 to June 2022 were retrospectively reviewed and collected.

RESULTS

All the patients underwent the operation smoothly without conversion. Division of the round ligament was performed for 33 hernias. Preservation of the round ligament was adopted for 148 hernias, 51 with the "keyhole" technique, 86 with the "longitudinal incision of peritoneum" method, and 11 with total dissection of the round ligament. The mean operative time was 55.6 ± 8.7 min for unilateral TAPP and 99.1 ± 15.8 min for bilateral TAPP. The mean estimated blood loss was 7.1 ± 4.5 mL. The postoperative complications included 6 (3.3%) cases of seroma, 1 (0.5%) case of hematoma, and 3 (1.6%) cases of mild chronic pain. The incidences of chronic pelvic pain and genital prolapse seemed to be higher in the division group than in the preservation groups (6.1% vs. 0.6% and 3.0% vs. 0%, separately). However, no statistical difference was observed (p > 0.05).

CONCLUSIONS

TAPP is feasible and effective for female patients with groin hernias, especially in preserving the round ligament of the uterus.

摘要

背景

腹腔镜经腹腹膜前修补术(TAPP)被推荐用于女性腹股沟疝患者。然而,只有少数研究关注是否以及如何在 TAPP 中保留子宫圆韧带。

方法

回顾性收集了 2016 年 1 月至 2022 年 6 月期间在中国一家机构接受 TAPP 治疗的 159 例女性 181 例腹股沟疝患者的临床资料。

结果

所有患者均顺利完成手术,无中转开腹。33 例疝行圆韧带切开,148 例保留圆韧带,其中 51 例行“钥匙孔”技术,86 例行“腹膜纵行切开”法,11 例行圆韧带完全解剖。单侧 TAPP 的平均手术时间为 55.6±8.7min,双侧 TAPP 的平均手术时间为 99.1±15.8min。平均估计出血量为 7.1±4.5ml。术后并发症包括 6 例(3.3%)血清肿、1 例(0.5%)血肿和 3 例(1.6%)轻度慢性疼痛。切开组慢性盆腔痛和生殖器脱垂的发生率似乎高于保留组(6.1%比 0.6%和 3.0%比 0%,分别)。然而,差异无统计学意义(p>0.05)。

结论

TAPP 是治疗女性腹股沟疝的一种可行且有效的方法,尤其在保留子宫圆韧带方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d8b/10413729/b84a038f232d/12905_2023_2527_Fig1_HTML.jpg

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