Yilmaz Abdullah Hilmi, Ulutas Mehmet Esref
Department of Surgery, Antalya Training and Research Hospital, University of Health Sciences, Varlık Mh. Kazım Karabekir Cd. 07100, Antalya, Türkiye.
Department of Surgery, Gaziantep City Hospital, University of Health Sciences, Gaziantep, Türkiye.
BMC Surg. 2025 Aug 9;25(1):355. doi: 10.1186/s12893-025-03105-2.
International guidelines recommend a laparoscopic approach in patients with recurrent inguinal hernia after open anterior repair. It is unclear which laparoscopic approach should be used. The aim of the study was to evaluate the safety and efficacy of the laparoscopic enhanced view-total extraperitoneal (eTEP) technique and total extraperitoneal (TEP) technique in the treatment of recurrent inguinal hernias.
The retrospective cohort study compared patients with unilateral recurrent inguinal hernia after anterior repair who underwent eTEP or TEP technique from February 2023 to February 2024. The two groups were compared in demographic characteristics and surgical and postsurgical data. The primary outcome of this study was recurrence and operation time.
A total of 62 patients were analyzed. The eTEP technique was performed on 32 patients, while the TEP technique was used on 30 patients. The mean follow-up period was 18.3 (± 5) months. There was no recurrence in either group. The mean operative time was 44.4 (± 10.4) minutes for the eTEP group and 45.7 (± 10.2) minutes for the TEP group (p = 0.62). Pneumoperitoneum occurred in 14 (43.7%) patients in the eTEP group and 20 (66.7%) patients in the TEP group (p = 0.07). The mean time to return to activities was 6.8 (± 2.7) days for the eTEP group and 6.9 (± 2.3) days for the TEP group (p = 0.57). Chronic pain was reported in only 1 (3.3%) patient in the TEP group (p = 0.48). The length of stay in the hospital was 1 day for both groups. Hematoma formation was observed in 3 (9.3%) patients in the eTEP group and 3 (10%) patients in the TEP group; seroma formation was reported in 2 (6.2%) and 2 (6.7%) patients, respectively (p = 0.99).
The eTEP technique demonstrated results similar to TEP, particularly regarding recurrence, operation time, and postoperative outcomes. Like TEP, eTEP is a safe and viable option for recurrent inguinal hernias. Furthermore, prospective randomized studies comparing these two techniques are necessary for recurrent inguinal hernias.
国际指南推荐对开放前路修补术后复发性腹股沟疝患者采用腹腔镜手术方式。目前尚不清楚应采用哪种腹腔镜手术方式。本研究的目的是评估腹腔镜增强视野完全腹膜外（eTEP）技术和完全腹膜外（TEP）技术治疗复发性腹股沟疝的安全性和有效性。
这项回顾性队列研究比较了2023年2月至2024年2月接受eTEP或TEP技术治疗的前路修补术后单侧复发性腹股沟疝患者。比较两组患者的人口统计学特征以及手术和术后数据。本研究的主要结局指标是复发率和手术时间。
共分析了62例患者。32例患者采用eTEP技术，30例患者采用TEP技术。平均随访时间为18.3（±5）个月。两组均无复发。eTEP组的平均手术时间为44.4（±10.4）分钟，TEP组为45.7（±10.2）分钟（p = 0.62）。eTEP组14例（43.7%）患者发生气腹，TEP组20例（66.7%）患者发生气腹（p = 0.07）。eTEP组平均恢复活动时间为6.8（±2.7）天，TEP组为6.9（±2.3）天（p = 0.57）。TEP组仅1例（3.3%）患者报告有慢性疼痛（p = 0.48）。两组住院时间均为1天。eTEP组3例（9.3%）患者出现血肿形成，TEP组3例（10%）患者出现血肿形成；分别有2例（6.2%）和2例（6.7%）患者报告有血清肿形成（p = 0.99）。
eTEP技术显示出与TEP相似的结果，特别是在复发率、手术时间和术后结局方面。与TEP一样，eTEP是复发性腹股沟疝的一种安全可行的选择。此外，对于复发性腹股沟疝，有必要进行比较这两种技术的前瞻性随机研究。
