Phillips E H, Arregui M, Carroll B J, Corbitt J, Crafton W B, Fallas M J, Filipi C, Fitzgibbons R J, Franklin M J, McKernan B
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Surg Endosc. 1995 Jan;9(1):16-21. doi: 10.1007/BF00187878.
Smaller individual series on the outcome of laparoscopic hernioplasty techniques have been reported. This study reports on the complications of 3,229 laparoscopic hernia repairs performed by the authors in 2,559 patients. The TAPP (transabdominal preperitoneal) technique was the most frequently performed: 1,944 (60%). The totally preperitoneal technique was performed 578 (18%) times. The IPOM (intraperitoneal onlay mesh) repair was performed 345 (11%) times. The plug-and-patch technique was used 286 (9%) times and simple closure of the hernia defect without mesh was used in 76 (2%) repairs. Overall, there were 336 (10%) complications: 17 (0.5%) major and 265 (8%) minor. There were 54 (1.6%) recurrences, with a mean follow-up of 22 months. The TAPP technique had 19 (1%) recurrences and 141 (7%) complications. There were four bowel obstructions in this subgroup from herniation of small bowel through the peritoneal closure and trocar sites. The totally preperitoneal technique had no recurrence and 60 (10%) complications. The IPOM group had 7 (2%) recurrences and 47 (14%) complications. The plug-and-patch technique had 26 (9%) recurrences and 24 (8%) complications. The simple closure of the internal ring had 2 (3%) recurrences and 10 (13%) complications. Laparoscopic hernioplasty is not without complications. Laparoscopic hernioplasty is not without complications. Training, experience, and attention to technique will prevent some of these complications.
已有关于腹腔镜疝修补术技术结果的较小规模的个体系列报道。本研究报告了作者对2559例患者进行的3229例腹腔镜疝修补术的并发症情况。经腹腹膜前修补术（TAPP）是最常施行的术式：1944例（60%）。完全腹膜外技术施行578例（18%）次。腹腔内补片修补术（IPOM）施行345例（11%）次。疝环充填式修补技术使用286例（9%）次，76例（2%）修补术采用单纯缝合疝缺损而不使用补片。总体而言，有336例（10%）并发症：17例（0.5%）为严重并发症，265例（8%）为轻微并发症。有54例（1.6%）复发，平均随访22个月。TAPP技术有19例（1%）复发和141例（7%）并发症。该亚组中有4例因小肠经腹膜缝合处和套管针穿刺部位疝出导致肠梗阻。完全腹膜外技术无复发，有60例（10%）并发症。IPOM组有7例（2%）复发和47例（14%）并发症。疝环充填式修补技术有26例（9%）复发和24例（8%）并发症。单纯内环缝合有2例（3%）复发和10例（13%）并发症。腹腔镜疝修补术并非没有并发症。腹腔镜疝修补术并非没有并发症。培训、经验以及对技术的关注将预防其中一些并发症。
