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腹腔镜经腹腹膜前修补术(TAPP)与李金斯坦无张力修补术治疗原发性单侧腹股沟疝术后短期并发症及一年后复发情况的比较

Comparison of Postoperative Short-term Complications and Recurrence after One Year between Laparoscopic Transabdominal Pre-peritoneal (TAPP) and Lichtenstein Tension Free Repair on the Treatment of Primary Unilateral Inguinal Hernia.

作者信息

Ashrafi Amir, Kabiri Alireza, Shayesteh Zadeh Behrouz, Sadri Peyman

机构信息

Department of General Surgery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

World J Plast Surg. 2024;13(3):87-91. doi: 10.61186/wjps.13.3.87.

Abstract

BACKGROUND

Inguinal hernia is one of the most common cases of elective surgery. Several methods are used to repair inguinal hernia, however, none of these methods have been introduced as the preferred method. Based on this, the current study was designed with the aim of comparing the postoperative short-term complications and recurrence after one year between laparoscopic transabdominal pre-peritoneal (TAPP) and Lichtenstein tension free repair in the treatment of primary unilateral inguinal hernia.

METHODS

In this clinical trial study, 122 patients who were candidates for inguinal hernia surgery in Ahvaz Golestan Hospital, Ahvaz, Southern Iran in 2022 were randomly assigned to two laparoscopic (TAPP) and open (Lichtenstein) surgery groups. Patients were compared in terms of short-term complications (hematoma, infection, seroma), post-surgery pain and number of hospitalization days, surgery duration, scar length and one-year recurrence rate.

RESULTS

Wound infection, seroma, and hematoma after surgery in the TAPP group were significantly less than the patients in the Lichtenstein group (=0.002). Pain intensity, recurrence rate and mean length of surgical scar in laparoscopic group patients were lower than open method group (=0.001). The mean duration of surgery in the laparoscopic group was higher than the Lichtenstein group, but there was no remarkable difference (=0.396). The mean duration of surgery in the TAPP group was higher than the Lichtenstein group, but there was no notable difference (=0.396).

CONCLUSIONS

The TAPP method has an obvious advantage over the conventional open surgery of Lichtenstein, especially in terms of reducing the initial postoperative pain and the occurrence of complications and recurrence after surgery.

摘要

背景

腹股沟疝是择期手术中最常见的病例之一。目前有多种方法用于修复腹股沟疝,但尚无一种方法被推荐为首选方法。基于此,本研究旨在比较腹腔镜经腹腹膜前修补术(TAPP)和李金斯坦无张力修补术治疗原发性单侧腹股沟疝术后的短期并发症及一年后的复发情况。

方法

在这项临床试验研究中,2022年伊朗南部阿瓦士戈勒斯坦医院122例腹股沟疝手术候选患者被随机分为腹腔镜手术(TAPP)组和开放手术(李金斯坦)组。比较两组患者的短期并发症(血肿、感染、血清肿)、术后疼痛、住院天数、手术时长、瘢痕长度及一年复发率。

结果

TAPP组术后伤口感染、血清肿和血肿明显少于李金斯坦组(P = 0.002)。腹腔镜组患者的疼痛强度、复发率及手术瘢痕平均长度低于开放手术组(P = 0.001)。腹腔镜组平均手术时长高于李金斯坦组,但差异无统计学意义(P = 0.396)。TAPP组平均手术时长高于李金斯坦组,但差异无显著意义(P = 0.396)。

结论

TAPP方法相较于传统的李金斯坦开放手术具有明显优势,尤其是在减轻术后初期疼痛以及减少术后并发症和复发方面。

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