Yang Bo, Xie Chang-Hu, Lv Yu-Xing, Wang Yin-Quan
Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, No. 99, Longcheng Street, Xiaodian District, Taiyuan, 030032, Shanxi Province, China.
Sci Rep. 2025 Jan 21;15(1):2593. doi: 10.1038/s41598-025-87188-0.
Transabdominal preperitoneal patch plasty (TAPP) versus total extraperitoneal patch plasty (TEP) are surgical techniques commonly used to treat inguinal hernia. However, studies indicate that both procedures may lead to significant complications, particularly gastrointestinal complications, some of which can be life-threatening. We statistically analyzed the complications caused by adult inguinal hernia patients admitted from 2018 to 2022. We focused on gastrointestinal complications and conducted a case-by-case analysis on their causes and treatment processes. A total of 1034 patients were included in the final analysis, with 783 patients receiving TAPP treatment and 251 patients undergoing TEP. The overall complication rate for the TAPP group was slightly higher at 4.72% compared to 3.58% in the TEP group, but the difference was not statistically significant (p = 0.446). The incidence of both common and gastrointestinal complications is similar between the two groups, with no significant difference observed. Five patients (0.48%) suffered gastrointestinal complications, one with gastric perforation after TEP surgery, and four during TAPP surgery. All five cases of gastrointestinal complications were Grade III or higher according to the Clavien-Dindo classification, and all required reoperation. Gastrointestinal complications, though rare in LIHR, often require readmission and reoperation. Attempting non-operative management of such complications may lead to disastrous consequences. The majority of these complications are attributed to improper use of surgical instruments, necessitating vigilance on the part of the surgical team in preventing them.
经腹腹膜前修补术（TAPP）与完全腹膜外修补术（TEP）是常用于治疗腹股沟疝的手术技术。然而，研究表明这两种手术都可能导致严重并发症，尤其是胃肠道并发症，其中一些可能危及生命。我们对2018年至2022年收治的成人腹股沟疝患者所引发的并发症进行了统计分析。我们聚焦于胃肠道并发症，并对其病因及治疗过程进行了逐例分析。最终分析共纳入1034例患者，其中783例接受TAPP治疗，251例接受TEP治疗。TAPP组的总体并发症发生率略高于TEP组，分别为4.72%和3.58%，但差异无统计学意义（p = 0.446）。两组常见并发症和胃肠道并发症的发生率相似，未观察到显著差异。5例患者（0.48%）出现胃肠道并发症，1例在TEP手术后发生胃穿孔，4例在TAPP手术期间发生。根据Clavien-Dindo分类，所有5例胃肠道并发症均为III级或更高等级，均需要再次手术。胃肠道并发症在腹腔镜腹股沟疝修补术中虽罕见，但往往需要再次入院和再次手术。尝试对这类并发症进行非手术处理可能会导致灾难性后果。这些并发症大多归因于手术器械使用不当，手术团队必须对此保持警惕以预防并发症。
