Velasco J M, Gelman C, Vallina V L
Department of Surgery, Rush University and Rush North Shore Medical Center, Skokie, IL 60076, USA.
Surg Endosc. 1996 Feb;10(2):122-7. doi: 10.1007/s004649910029.
Simultaneous repair of bilateral inguinal hernia remains controversial.
Seventy-two consecutive patients underwent a preperitoneal prosthetic repair of bilateral groin hernia; 25 via laparoscopy. ASA classification, Nyhus type, hospitalization, convalescence time, and cost were examined. Mean follow-up was 36 and 12 months for the conventional and laparoscopic group respectively.
Sixty-nine patients were available for long-term follow-up. Average hospital stay, recurrence rate, perioperative urinary retention, transient thigh neuralgia, and return to normal activities were 48 hours, 5%, 9%, 6%, and 22 days as compared to 4 hours, 6%, 20%, 12%, and 9 days for the conventional and laparoscopic group respectively. The cost for laparoscopic repair was $500 greater.
The preperitoneal approach to repair of bilateral hernias demonstrates an acceptable recurrence rate with low long-term morbidity. Experience with conventional preperitoneal technique greatly facilitates transition to laparoscopic repair.
双侧腹股沟疝的同期修补仍存在争议。
连续72例患者接受双侧腹股沟疝的腹膜前假体修补术；其中25例通过腹腔镜进行。对美国麻醉医师协会（ASA）分级、纽赫斯（Nyhus）分型、住院情况、康复时间及费用进行了检查。传统组和腹腔镜组的平均随访时间分别为36个月和12个月。
69例患者可进行长期随访。传统组和腹腔镜组的平均住院时间、复发率、围手术期尿潴留、短暂性股神经痛及恢复正常活动时间分别为48小时、5%、9%、6%和22天，以及4小时、6%、20%、12%和9天。腹腔镜修补的费用高出500美元。
腹膜前修补双侧疝的方法显示出可接受的复发率，且长期发病率较低。传统腹膜前技术的经验极大地有助于向腹腔镜修补的转变。
