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在完全腹膜外(TEP)腹股沟疝修补术中偶然发现闭孔疝:单中心经验。

Incidentally found obturator hernias during totally extraperitoneal (TEP) inguinal hernia repair: a single-center experience.

机构信息

Department of General Minimally Invasive and Trauma Surgery, Francis Raszeja Municipal Hospital, Mickiewicza 2 Street, 60-834, Poznan, Poland.

Department of General and Oncologic Surgery, St. Joseph Hospital, Mikolow, Poland.

出版信息

Hernia. 2024 Aug;28(4):1145-1149. doi: 10.1007/s10029-024-02991-4. Epub 2024 Mar 15.

Abstract

PURPOSE

This study aimed to determine the occurrence of incidental obturator hernia and clinical risk factors of their appearance in patients undergoing totally extraperitoneal (TEP) inguinal hernioplasty.

METHODS

Data were collected retrospectively from patients who underwent TEP inguinal hernioplasty between June 2020 and December 2022.

RESULTS

A total of 251 patients were included in the study. Obturator hernias were found in 21 patients (8.4%). At admission, no patient presented clinical signs of an obturator hernia. There was a significant predominance of women in the obturator hernia compared to the non-obturator hernia group (28.6% vs. 10.9%, respectively, p=0.018). There was no correlation between age (p=0.479) and BMI (p=0.771) and the occurrence of obturator hernia. Additional obturator hernia repair within the TEP inguinal hernioplasty procedure did not influence the overall length of the surgery (60.86 minutes) compared to the standard TEP inguinal hernioplasty (61.09 minutes, p=0.876).

CONCLUSIONS

The TEP inguinal hernioplasty allows the detection and repair of incidental obturator hernia. Through thorough inspection of the obturator canal, an asymptomatic obturator hernia can be detected and adequately treated within the same procedure, without the impact on the surgery duration, when performed by an experienced hernia surgeon.

摘要

目的

本研究旨在确定在接受完全腹膜外(TEP)腹股沟疝修补术的患者中,偶然发生闭孔疝的发生率和其出现的临床危险因素。

方法

从 2020 年 6 月至 2022 年 12 月期间接受 TEP 腹股沟疝修补术的患者中回顾性收集数据。

结果

共有 251 名患者纳入研究。21 名患者(8.4%)发现闭孔疝。入院时,没有患者出现闭孔疝的临床体征。与非闭孔疝组相比,闭孔疝组中女性明显居多(分别为 28.6%和 10.9%,p=0.018)。年龄(p=0.479)和 BMI(p=0.771)与闭孔疝的发生之间无相关性。在 TEP 腹股沟疝修补术中额外进行闭孔疝修补术并不会影响手术的总时长(60.86 分钟),与标准 TEP 腹股沟疝修补术相比(61.09 分钟,p=0.876)。

结论

TEP 腹股沟疝修补术可发现和修复偶然发生的闭孔疝。通过对闭孔管进行彻底检查,经验丰富的疝外科医生可以在同一手术过程中发现无症状的闭孔疝并进行充分治疗,而不会影响手术时间。

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