Basukala Sunil, Shrestha Oshan, Chhetri Suchit Thapa, Thapa Niranjan, Oli Samana, Mehta Bipin K, Pokhrel Nabin, Tiwari Bishal
Department of Surgery Nepalese Army Institute of Health Sciences Kathmandu Nepal.
Department of Anaesthesiology Manmohan Cardiothoracic Vascular and Transplant Center Kathmandu Nepal.
Health Sci Rep. 2024 Dec 17;7(12):e70270. doi: 10.1002/hsr2.70270. eCollection 2024 Dec.
Inguinal hernias are encountered commonly, but there is a lack of uniformity and standardization in repair techniques. There are a variety of repair methods, from open methods to laparoscopic approaches. The available laparoscopic techniques that exist for inguinal hernia repair are transabdominal preperitoneal (TAPP) repair and totally extraperitoneal (TEP) repair. This study aims to compare the outcomes of these two laparoscopic procedures.
The study was initiated after receiving ethical clearance. This single-centric retrospective study included the patients that underwent laparoscopic inguinal hernia repair from January 1, 2020, to December 31, 2023. Patient records were reviewed and assessed against the inclusion criteria of the study. Systematic random sampling was applied to select patients from the records. A structured questionnaire was prepared for the purpose of data collection. The data were refined and analyzed using the SPSS software.
A total of 200 patients (100 in each group) who underwent laparoscopic repair of an inguinal hernia were part of this study. The median (IQR) age of patients in the TAPP group was 50 (41.25-64.75) years, and that in the TEP group was 48.5 (39.25-64.75) years. The TAPP procedure took a median (IQR) time of 81 (77-88) min, while the TEP procedure took 69 (66-73) min to finish. The patients in the TAPP group returned to their normal activities after 15 (14-16) days of surgery, and the patients in the TEP group returned after 13 (11-14) days. The pain score at 1 week was found to be better in the TEP group. No difference was observed in complications or recurrence.
TEP repair was found to be superior to TAPP repair in terms of procedural time, return to normal activities, and pain score at 1 week.
腹股沟疝较为常见,但修复技术缺乏统一性和标准化。修复方法多种多样,从开放手术到腹腔镜手术。现有的腹股沟疝腹腔镜修复技术包括经腹腹膜前(TAPP)修补术和完全腹膜外(TEP)修补术。本研究旨在比较这两种腹腔镜手术的效果。
在获得伦理批准后启动该研究。这项单中心回顾性研究纳入了2020年1月1日至2023年12月31日期间接受腹腔镜腹股沟疝修补术的患者。根据研究的纳入标准对患者记录进行审查和评估。采用系统随机抽样从记录中选择患者。为此编制了一份结构化问卷用于数据收集。使用SPSS软件对数据进行整理和分析。
共有200例接受腹股沟疝腹腔镜修补术的患者参与了本研究(每组100例)。TAPP组患者的年龄中位数(四分位间距)为50(41.25 - 64.75)岁,TEP组为48.5(39.25 - 64.75)岁。TAPP手术的中位(四分位间距)时间为81(77 - 88)分钟,而TEP手术完成时间为69(66 - 73)分钟。TAPP组患者在术后15(14 - 16)天恢复正常活动,TEP组患者在术后13(11 - 14)天恢复。发现TEP组在术后1周时的疼痛评分更好。并发症或复发方面未观察到差异。
在手术时间、恢复正常活动以及术后1周的疼痛评分方面,发现TEP修补术优于TAPP修补术。