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腹腔镜完全腹膜外修补单侧可复性腹股沟疝术后生活质量。

Quality of life following laparoscopic totally extraperitoneal repair of a unilateral reducible inguinal hernia.

机构信息

Department of General Surgery, Hospital Sultanah Aminah, Ministry of Health Malaysia, Johor Bahru, Malaysia.

Department of General Surgery, Hospital Umum Sarawak, Ministry of Health Malaysia, Kuching, Malaysia.

出版信息

Asian J Endosc Surg. 2024 Jul;17(3):e13320. doi: 10.1111/ases.13320.

Abstract

BACKGROUND

Laparoscopic totally extraperitoneal (TEP) inguinal hernia repair has become increasingly favored over open Lichtenstein tension-free mesh repair owing to its associated benefits, including reduced postoperative pain, early return to normal activities, and a comparable recurrence rate. In recent years, emphasis has been placed on patient-reported outcomes, particularly health-related quality of life (QOL), as a critical metric for evaluating surgical success. This study aimed to evaluate the overall QOL following laparoscopic TEP repair of unilateral inguinal hernia.

METHODS

This prospective study enrolled patients aged 18 years or older who underwent elective laparoscopic TEP hernia repair for unilateral inguinal hernia from April 2020 to March 2022. Data collected include demographic details, hernia characteristics, postoperative complications, and postoperative QOL assessment. The Short Form 36 Health Survey Version 2 (SF-36v2), a validated general QoL questionnaire, was administered preoperatively and at 1 month, 6 months, and 1 year postoperatively. Statistical analysis utilized paired t-tests for comparisons, with significance set at a p-value <.05.

RESULTS

A cohort of 49 patients, with a mean (standard deviation) age of 56.7 (14.0) years, predominantly comprising 47 men, was available for evaluation. Complications were observed in three (6.1%) of cases, with seroma/hematoma occurring in two patients and a wound infection necessitating antibiotic treatment in one patient. Notably, there were no instances of recurrence during the study period. Postoperative assessments revealed significant improvements in both physical and mental health at 1 month, with continued improvement noted up to 12 months.

CONCLUSION

Laparoscopic TEP inguinal hernia repair has been shown to improve both physical and mental health in patients with unilateral reducible inguinal hernia, with the majority of the improvement typically occurring within the initial month following surgery. It is crucial to communicate these improvement trends to patients undergoing hernia repair to help manage their expectations effectively.

摘要

背景

腹腔镜完全腹膜外(TEP)腹股沟疝修补术因其相关益处,包括减少术后疼痛、早期恢复正常活动和可比的复发率,已越来越受到青睐,优于开放式 Lichtenstein 无张力网修补术。近年来,人们越来越重视患者报告的结果,特别是健康相关生活质量(QOL),作为评估手术成功的关键指标。本研究旨在评估单侧腹股沟疝腹腔镜 TEP 修补术后的总体 QOL。

方法

本前瞻性研究纳入了 2020 年 4 月至 2022 年 3 月期间因单侧腹股沟疝接受择期腹腔镜 TEP 疝修补术的年龄在 18 岁或以上的患者。收集的数据包括人口统计学细节、疝特征、术后并发症和术后 QOL 评估。使用经过验证的一般 QOL 问卷短表 36 健康调查版本 2(SF-36v2)在术前和术后 1 个月、6 个月和 1 年进行评估。统计分析采用配对 t 检验进行比较,显著性水平设为 p 值<.05。

结果

49 例患者(平均[标准差]年龄 56.7[14.0]岁,主要为 47 名男性)可用于评估。3 例(6.1%)发生并发症,2 例出现血清肿/血肿,1 例发生伤口感染需要抗生素治疗。值得注意的是,研究期间无复发病例。术后评估显示,1 个月时身体和心理健康均有显著改善,12 个月时仍有改善。

结论

腹腔镜 TEP 腹股沟疝修补术可改善单侧可复性腹股沟疝患者的身体和心理健康,大多数改善通常发生在术后最初一个月内。在接受疝修补术的患者中,沟通这些改善趋势至关重要,以帮助他们有效管理期望。

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