Filipi C J, Gaston-Johansson F, McBride P J, Murayama K, Gerhardt J, Cornet D A, Lund R J, Hirai D, Graham R, Patil K, Fitzgibbons R, Gaines R D
Creighton University School of Medicine, Department of Surgery, 601 N. 30th St., Omaha, NE 68131, USA.
Surg Endosc. 1996 Oct;10(10):983-6. doi: 10.1007/s004649900219.
Laparoscopic herniorrhaphy is controversial and deserves critical evaluation.
In a randomized prospective study transabdominal preperitoneal laparoscopic herniorrhaphy (n = 24) was compared in patients to the tension-free Lichtenstein repair (n = 29) utilizing validated and reliable pain and activity assessment tools. The Sickness Impact Profile (SIP) was used to compare preoperative normal activity to postoperative activity. A Pain-O-Meter (visual analogue scale plus affective and sensory pain descriptors) assessed intensity of pain. The total pain assessment score and SIP were compared across time (postoperative day 1-42). Analgesic medication was used as a covariate.
The total pain score was less for laparoscopic herniorrhaphy but this did not reach statistical significance. Similarly, the SIP showed modest improvement for laparoscopic herniorrhaphy. No differences between groups were noted for morphine equivalents of administered analgesics or length of hospitalization.
Further investigation of laparoscopic herniorrhaphy is warranted.
腹腔镜疝修补术存在争议，值得进行批判性评估。
在一项随机前瞻性研究中，使用经过验证且可靠的疼痛和活动评估工具，将24例患者的经腹腹膜前腹腔镜疝修补术与29例患者的无张力Lichtenstein修补术进行比较。使用疾病影响量表（SIP）比较术前正常活动与术后活动。疼痛计量仪（视觉模拟量表加上情感和感觉疼痛描述）评估疼痛强度。比较整个时间段（术后第1 - 42天）的总疼痛评估得分和SIP。将镇痛药物用作协变量。
腹腔镜疝修补术的总疼痛评分较低，但未达到统计学意义。同样，SIP显示腹腔镜疝修补术有适度改善。在给予的镇痛药物的吗啡当量或住院时间方面，两组之间未发现差异。
有必要对腹腔镜疝修补术进行进一步研究。
