Moreno-Suero Francisco, Tallon-Aguilar Luis, Tinoco-González José, Sánchez-Arteaga Alejandro, Suárez-Grau Juan Manuel, Alvarez-Aguilera Miriam, Morales-Conde Salvador, Padillo-Ruiz Javier
Virgen del Rocío University Hospital, Seville, Spain.
J Abdom Wall Surg. 2023 Jun 16;2:11242. doi: 10.3389/jaws.2023.11242. eCollection 2023.
There is currently no consensus or homogeneous recommendation about the role of the laparoscopic approach in emergent inguinal hernia surgery. The aim of this manuscript is showing our experience and results of laparoscopic approach for emergent groin hernia repair comparing with open approach. A retrospective review of a prospectively maintained database between January 2011 and December 2021 of acute incarcerated groin hernia that were operated at Virgen del Rocio University Hospital. In this period, they were identified 463 patients with groin hernia that required an emergency repair. 454 patients underwent open surgery (group 1) and 36 patients underwent laparoscopic approach (TAPP procedure) (group 2). Median length stay was 1 day in lap group and 2 days in open approach. Reintervention was necessary in 20 cases (4.40%) from group 1 and one (2.27%) from group 2. In laparoscopic approach, no mortality was described but in open approach, 10 patients (2.20%) died. Globally, 58 cases (12.77%) from group 1 and six patients (16.66%) from group 2 presented any complication. Wound infection was higher in group of open repairs (5.94% vs. 2.77%). Non-surgical complications were higher in open approach (19 vs. 0). There is no statistical significance in any of these items. Laparoscopic approach is a safe, feasible and effective therapeutic option for the treatment of incarcerated groin hernia that require emergency surgery, but prospective and randomized comparative studies are needed to establish the best approach.
目前，对于腹腔镜手术在急诊腹股沟疝手术中的作用，尚无共识或统一的推荐意见。本文的目的是展示我们采用腹腔镜手术治疗急诊腹股沟疝的经验和结果，并与开放手术进行比较。对2011年1月至2021年12月在罗西奥圣母大学医院接受手术的急性嵌顿性腹股沟疝患者的前瞻性维护数据库进行回顾性分析。在此期间，共确定了463例需要急诊修复的腹股沟疝患者。454例患者接受了开放手术（第1组），36例患者接受了腹腔镜手术（经腹腹膜前修补术，TAPP手术）（第2组）。腹腔镜组的中位住院时间为1天，开放手术组为2天。第1组有20例（4.40%）需要再次干预，第2组有1例（2.27%）。在腹腔镜手术中，未描述有死亡病例，但在开放手术中，有10例患者（2.20%）死亡。总体而言，第1组有58例（12.77%）出现任何并发症，第2组有6例患者（16.66%）出现并发症。开放修复组的伤口感染率更高（5.94%对2.77%）。开放手术的非手术并发症更多（19例对0例）。这些项目中均无统计学意义。腹腔镜手术是治疗需要急诊手术的嵌顿性腹股沟疝的一种安全、可行且有效的治疗选择，但需要进行前瞻性和随机对照研究以确定最佳手术方式。
