Topal B, Hourlay P
Department of Gastrointestinal Surgery, Salvator Ziekenhuis Hospital, Hasselt, Belgium.
Br J Surg. 1997 Jan;84(1):61-3.
Recurrence rate after conventional inguinal hernia repair is high. However, the Stoppa technique has provided the best results. The totally preperitoneal endoscopic inguinal hernia repair is developed in order to combine the results of the Stoppa technique with the advantages of minimally invasive surgery.
Between October 1992 and August 1994, 403 patients with a total of 632 inguinal hernias, including 82 recurrences, were treated by totally preperitoneal endoscopic inguinal hernia repair with mesh placement of at least 10 x 15 cm.
Mean(s.e.m.) operating time was 42(1.2) min for unilateral and 58(1.0) min for bilateral hernia repair. Mean(s.e.m.) postoperative hospital stay was 2(0.04) days. Complication rates during and after operation were 0.3 and 3.3 per cent respectively. The morbidity rate at 1 month after operation was 3.5 per cent. The recurrence rate was 0.3 per cent at 1-year follow-up.
Totally preperitoneal endoscopic inguinal hernia repair is safe and reproducible for any type of primary or recurrent inguinal hernia, even in patients with previous subumbilical surgery or severe systemic disease. Careful follow-up is mandatory to assess the late recurrence rate.
传统腹股沟疝修补术后复发率较高。然而，斯托帕技术取得了最佳效果。完全腹膜前内镜腹股沟疝修补术是为了将斯托帕技术的效果与微创手术的优势相结合而发展起来的。
1992年10月至1994年8月，403例共632例腹股沟疝患者，包括82例复发性疝，接受了完全腹膜前内镜腹股沟疝修补术，并放置至少10×15 cm的补片。
单侧疝修补术平均（标准误）手术时间为42（1.2）分钟，双侧疝修补术为58（1.0）分钟。平均（标准误）术后住院时间为2（0.04）天。手术中和术后的并发症发生率分别为0.3%和3.3%。术后1个月的发病率为3.5%。1年随访时的复发率为0.3%。
完全腹膜前内镜腹股沟疝修补术对于任何类型的原发性或复发性腹股沟疝都是安全且可重复的，即使是既往有脐下手术或严重全身性疾病的患者。必须进行仔细的随访以评估晚期复发率。
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