Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Sultan Qaboos Univ Med J. 2024 May;24(2):186-193. doi: 10.18295/squmj.1.2024.001. Epub 2024 May 27.
This study aimed to evaluate the outcomes of laparoscopic inguinal hernia repair (LIHR) regarding postoperative pain, recurrence rates, duration of hospital stay and other postoperative outcomes within the context of a tertiary care teaching hospital in South India, and the initial experience of laparoscopic repairs. The current consensus in the literature often suggests LIHR as superior to open inguinal hernia repair (OIHR).
This single-centre, retrospective, observational study was conducted at the Jawaharlal Institute of Postgraduate Education and Research, Puducherry, India, from January 2011 to September 2020. All patients who underwent elective OIHR and LIHR were included. Data on the patients demographics, comorbidities, hernia type, mesh characteristics, surgery duration, hospital stay and immediate postoperative complications were collected and analysed.
A total of 2,690 OIHR and 158 LIHR cases were identified. The demographic profiles, hospital stay and complication rates were similar in both groups. However, surgical site infection was present exclusively in the OIHR group (3.55% versus 0.0%; <0.05). The timeline for returning to normal activities was statistically shorter for the LIHR group (6 versus 8 days; <0.05). The most frequent immediate complication in the LIHR group was subcutaneous emphysema (6.54% versus 0.0%; <0.05). Recurrence (9.23% versus 3.61%; = 0.09) and chronic pain (41.53% versus 13.55%; <0.05) were higher in the LIHR group.
Lower recurrence and chronic pain rates were observed with OIHR in the initial experience with LIHR in the hospital. However, LIHR had significant advantages concerning faster patient recovery and lower rates of surgical site infections. While the results contribute an interesting deviation from the standard narrative, they should be interpreted within the context of a learning curve associated with the early experience of the research team with LIHR.
本研究旨在评估腹腔镜腹股沟疝修补术（LIHR）在印度南部一家三级教学医院的术后疼痛、复发率、住院时间和其他术后结果方面的结果，并评估腹腔镜修补术的初步经验。文献中的现有共识通常表明 LIHR 优于开放式腹股沟疝修补术（OIHR）。
这是一项在印度本地治里的贾瓦哈拉尔·尼赫鲁高等教育研究所进行的单中心、回顾性、观察性研究，时间为 2011 年 1 月至 2020 年 9 月。所有接受选择性 OIHR 和 LIHR 的患者均被纳入研究。收集并分析了患者人口统计学、合并症、疝类型、网片特征、手术时间、住院时间和术后即刻并发症的数据。
共发现 2690 例 OIHR 和 158 例 LIHR 病例。两组的人口统计学特征、住院时间和并发症发生率相似。然而，手术部位感染仅存在于 OIHR 组（3.55%比 0.0%；<0.05）。LIHR 组恢复正常活动的时间明显更短（6 天比 8 天；<0.05）。LIHR 组最常见的即刻并发症是皮下气肿（6.54%比 0.0%；<0.05）。LIHR 组的复发率（9.23%比 3.61%；=0.09）和慢性疼痛率（41.53%比 13.55%；<0.05）更高。
在医院进行 LIHR 的初步经验中，OIHR 观察到复发率和慢性疼痛率较低。然而，LIHR 在患者恢复更快和手术部位感染率更低方面具有显著优势。虽然这些结果与标准叙述有有趣的偏离，但应在研究团队进行 LIHR 早期经验相关的学习曲线的背景下进行解释。
