Sarli L, Pietra N, Choua O, Costi R, Cattaneo G
Institute of Clinica Chirurgica Generale and Terapia Chirurgica, School of Medicine, University of Parma, Italy.
Surg Laparosc Endosc. 1997 Dec;7(6):472-6.
The aim of the study was to evaluate the safety and efficacy of two techniques of laparoscopic hernia repair: the transabdominal preperitoneal technique (TAPP) and the intraperitoneal onlay mesh technique (IPOM). In May 1992 a prospective randomized trial was initiated to compare TAPP and IPOM. Until October 1994, 115 patients with 148 hernias took part in the trial (59 TAPP and 56 IPOM). The TAPP took significantly longer than did the IPOM. There were no intraoperative complications, conversions to open repair, or postoperative deaths in either group. There were 10 (16.9% of patients) postoperative complications in the TAPP group and 14 (25%) in the IPOM group. The difference was not statistically significant. Neuralgias occurred in 3 cases of TAPP and 11 cases of IPOM (p < 0.05), local hematoma in 6 cases of TAPP and 3 cases of IPOM (NS), and urinary retention in 1 case of TAPP and in no case of IPOM (NS). Recurrences occurred in no cases of TAPP and in 8 cases (11.1% of hernias) of IPOM (p < 0.01). The results of the present report suggest that the IPOM technique for laparoscopic hernia repair should be avoided, whereas TAPP appears to be an excellent technique with no early recurrences.
经腹腹膜前修补术（TAPP）和腹腔内置片修补术（IPOM）。1992年5月启动了一项前瞻性随机试验，以比较TAPP和IPOM。到1994年10月，115例患有148处疝的患者参与了该试验（59例行TAPP，56例行IPOM）。TAPP手术时间明显长于IPOM。两组均未发生术中并发症、转为开放手术或术后死亡。TAPP组有10例（占患者的16.9%）术后并发症，IPOM组有14例（占25%）。差异无统计学意义。TAPP组3例发生神经痛，IPOM组11例（p<0.05）；TAPP组6例发生局部血肿，IPOM组3例（无显著性差异）；TAPP组1例发生尿潴留，IPOM组无（无显著性差异）。TAPP组无复发病例，IPOM组有8例（占疝的11.1%）复发（p<0.01）。本报告结果表明，应避免使用IPOM技术进行腹腔镜疝修补，而TAPP似乎是一种无早期复发的优秀技术。
