Dokania Manoj Kumar, Ankur Ankur, Agarwal Nitin, Jain Atul, Anshu Anshu, Singh Rana A K
Department of Surgery, ABVIMS & Dr RML Hospital, New Delhi, India.
J West Afr Coll Surg. 2024 Jan-Mar;14(1):69-75. doi: 10.4103/jwas.jwas_76_23. Epub 2023 Dec 14.
Hernia may be defined as a protrusion of viscus through layers anatomically designed to contain that viscus. Most abdominal hernias occur at well-described sites of potential weakness. Repair of inguinal hernia is one of the most common operations in general surgery. Objectives: To compare the perioperative complication rates of total extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) repairs of primary inguinal hernias.
It is a randomised comparative study, conducted at the department of general surgery. A total of 50 patients were included and divided into two groups with 25 in each. Group A represents the laparoscopic TEP repair and group B represents the laparoscopic TAPP repair. Patients above 18 years with primary unilateral inguinal hernia were included. Patients having complicated inguinal hernia and history of previous abdominal surgery were excluded.
We observed that hernia occurrence is more common in the 31-50 years of age group and right-sided hernia is more common. Scrotal oedema and conversion to open surgery chances are similar in both TEP and TAPP groups. The duration of surgery in TEP is significantly higher as compared to TAPP. Patients who underwent TEP experienced less pain as compared to TAPP as per visual analogue scale. Postoperative hospital stay and time taken to resume the routine activity were significantly less in case of TEP.
TEP is preferred over TAPP for laparoscopic hernia repair because it preserves the peritoneal integrity and has lesser postoperative pain. The early recovery and return to the routine work were seen with the patient treated with the TEP and also showed better visual analogue score than the TAPP repair group.
疝可定义为脏器通过解剖学上用于容纳该脏器的各层组织的突出。大多数腹疝发生在公认的潜在薄弱部位。腹股沟疝修补术是普通外科最常见的手术之一。目的：比较原发性腹股沟疝全腹膜外（TEP）修补术和经腹腹膜前（TAPP）修补术的围手术期并发症发生率。
这是一项在普通外科进行的随机对照研究。共纳入50例患者，分为两组，每组25例。A组代表腹腔镜TEP修补术，B组代表腹腔镜TAPP修补术。纳入年龄在18岁以上的原发性单侧腹股沟疝患者。排除患有复杂性腹股沟疝和既往有腹部手术史的患者。
我们观察到疝在31 - 50岁年龄组中更常见，右侧疝更常见。TEP组和TAPP组的阴囊水肿和转为开放手术的几率相似。与TAPP相比，TEP的手术时间明显更长。根据视觉模拟评分，接受TEP的患者比接受TAPP的患者疼痛更少。TEP患者的术后住院时间和恢复日常活动所需时间明显更短。
对于腹腔镜疝修补术，TEP优于TAPP，因为它保留了腹膜的完整性，术后疼痛较轻。接受TEP治疗的患者恢复较早并能回归日常工作，且视觉模拟评分也优于TAPP修补组。
