Aragone Lucía, Rosasco Nicolás, Gutierrez Juana, Croceri Raul, Medina Pablo, Pirchi Daniel
Abdominal Wall Unit, General Surgery Department, British Hospital of Buenos Aires, Buenos Aires, Argentina.
J Abdom Wall Surg. 2025 Mar 11;4:14408. doi: 10.3389/jaws.2025.14408. eCollection 2025.
The feasibility of laparoscopic treatment for inguinocrural-hernias (ICH) and its advantages over open techniques have already been demonstrated. Nonetheless, there is still no sufficient literature regarding laparoscopy for incarcerated or strangulated ICH in the emergency setting. Our primary outcome was to evaluate the feasibility and safety of laparoscopic surgery (LS) for complicated ICH by comparing outcomes to open surgery (OS).
A comparative retrospective study with prospective case registry was conducted. All patients who underwent ICH repair due to complicated hernias from January 2003 to December 2023 were analyzed and divided into groups according to the approach during surgery: OS (by Lichtenstein technique) or LS (by transabdominal preperitoneal approach). Demographic variables, hernia size and type, surgical time, length of stay, recurrence and other morbidities were compared between groups.
A total of 8282 ICH were operated in the studied period, out of which 162 were included in the study due to incarceration or strangulation. Of these, 83 were treated by OS, while 79 underwent LS. LS showed a reduction in surgical time (70 min IQR60-103 vs. 117 min IQR100-120; p 0.03), length of stay (1.9 days ± 1.4 vs. 2.9 days ± 3.1; p 0.01) and total morbidities (6.3% vs, 16.8%; p 0.04), with a similar recurrence rate (1.2% vs. 1.2%; p1) when compared to OS group.
Laparoscopic surgery for the treatment of complicated inguinocrural-hernias is a feasible and safe approach. It allows the benefits of minimally invasive surgery, including shorter surgical time, shorter length of stay and fewer postoperative morbidities, without increasing recurrence rate compared to open surgery.
腹腔镜治疗腹股沟股疝（ICH）的可行性及其相对于开放手术的优势已经得到证实。然而，在急诊情况下，关于腹腔镜治疗嵌顿性或绞窄性ICH的文献仍然不足。我们的主要结果是通过比较腹腔镜手术（LS）与开放手术（OS）的结果，评估其治疗复杂性ICH的可行性和安全性。
进行了一项带有前瞻性病例登记的比较性回顾性研究。分析了2003年1月至2023年12月期间因复杂性疝接受ICH修复的所有患者，并根据手术方式分为两组：OS组（采用Lichtenstein技术）或LS组（采用经腹腹膜前入路）。比较两组之间的人口统计学变量、疝的大小和类型、手术时间、住院时间、复发率和其他并发症。
在研究期间共进行了8282例ICH手术，其中162例因嵌顿或绞窄而纳入研究。其中，83例接受OS治疗，79例接受LS治疗。与OS组相比，LS组的手术时间缩短（70分钟，四分位数间距60 - 103 vs. 117分钟，四分位数间距100 - 120；p = 0.03）、住院时间缩短（1.9天±1.4 vs. 2.9天±3.1；p = 0.01）和总并发症减少（6.3% vs. 16.8%；p = 0.04），复发率相似（1.2% vs. 1.2%；p = 1）。
腹腔镜手术治疗复杂性腹股沟股疝是一种可行且安全的方法。它具有微创手术的优点，包括手术时间短、住院时间短和术后并发症少，与开放手术相比不增加复发率。
