Dion Y M
Department of Surgery, Hôpital Saint-François d'Assise and Université Laval, Québec, Que.
Can J Surg. 1996 Jun;39(3):229-32.
To assess the safety and effectiveness of individualized laparoscopic herniorrhaphy and to compare its intraoperative cost to that of the standard Bassini operation.
An analytic cohort study.
A university teaching hospital.
One group of 158 patients underwent 167 laparoscopic herniorrhaphies for symptomatic groin hernias. The approach was transabdominal preperitoneal for the first 124 patients and totally preperitoneal for the last 34 patients. A second group of 50 patients underwent a conventional Bassini operation.
Individualized laparoscopic inguinal herniorrhaphy or Bassini herniorrhaphy.
Complications and recurrences encountered in the laparoscopic group. Total operative time and intraoperative cost involved in both procedures. Analgesia required in each group during the first 2 postoperative days.
Intra- and postoperative complications of the laparoscopic approach were not life threatening. The recurrence rate at a mean follow-up of 16.8 months was 1.2%. Total operative time was significantly (p < 0.001) longer in the laparoscopy group than in the Bassini group. Patients in the Bassini group took more parenteral analgesics than those in the laparoscopy group (p = 0.02), but there was no difference with respect to the number of times enteral analgesics were required (p = 0.32). Use of mesh and staples was more expensive than sutures alone inserted laparoscopically. The Bassini procedure was a less expensive procedure than laparoscopic herniorrhaphy.
The laparoscopic treatment of groin hernias is safe. The recurrence rate is low. Primary unilateral inguinal hernias could be adequately treated at a lesser cost by a standard approach. Bilateral, recurrent and femoral hernias could benefit from a laparoscopic approach.
评估个体化腹腔镜疝修补术的安全性和有效性，并将其术中成本与标准 Bassini 手术的成本进行比较。
一项分析性队列研究。
一所大学教学医院。
一组 158 例患者接受了 167 次针对有症状腹股沟疝的腹腔镜疝修补术。前 124 例患者采用经腹腹膜前入路，后 34 例患者采用完全腹膜前入路。另一组 50 例患者接受了传统的 Bassini 手术。
个体化腹腔镜腹股沟疝修补术或 Bassini 疝修补术。
腹腔镜组出现的并发症和复发情况。两种手术的总手术时间和术中成本。每组术后前两天所需的镇痛措施。
腹腔镜手术的术中和术后并发症均不危及生命。平均随访 16.8 个月时的复发率为 1.2%。腹腔镜组的总手术时间显著长于 Bassini 组（p < 0.001）。Bassini 组患者使用的胃肠外镇痛药比腹腔镜组多（p = 0.02），但在肠内镇痛药的使用次数方面没有差异（p = 0.32）。使用补片和吻合器比单纯腹腔镜缝合更昂贵。Bassini 手术的成本低于腹腔镜疝修补术。
腹腔镜治疗腹股沟疝是安全的。复发率低。原发性单侧腹股沟疝采用标准方法治疗成本较低。双侧、复发性和股疝可从腹腔镜手术中获益。
