Van Hee R, Goverde P, Hendrickx L, Van der Schelling G, Totté E
Academic Surgical Center Stuivenberg, University of Antwerp-UIA, Belgium.
Acta Chir Belg. 1998 Jun;98(3):132-5.
A prospective series of 106 inguinal hernias in 91 patients is studied, comparing two methods of laparoscopic hernia repair: a transperitoneal technique with preperitoneal stapled mesh fixation (TransAbdominal PrePeritoneal or TAPP-technique) performed in 33 patients, and a totally extraperitoneal placement of non stapled mesh (Totally ExtraPeritoneal Approach or TEPA-technique) performed in 58 patients. Conversions to open repair were equally frequent (5% vs. 7% respectively) and were due to adhesions, haemorrhage, irreducible intestinal loop in the hernial sac or important subcutaneous emphysema. Minor postoperative complications included regional seroma or haematoma, testicular pain and meralgia paraesthetica. There was no mortality nor long lasting complication. Recurrence rates in both groups amounted 2.7% (TAPP) and 2.8% (TEPA) respectively after a mean follow-up of 15.8 months (TAPP) and 17.6 months (TEPA). In both groups early recovery of normal activities was noted, after a mean of respectively 13.6 days (TAPP) and 12.9 days (TEPA). It is concluded that the transabdominal route and the totally extraperitoneal approach for laparoscopic herniorrhaphy are both adequate techniques for inguinal hernia repair with similar complication and short-term recurrence rates.
对91例患者的106例腹股沟疝进行了前瞻性研究，比较了两种腹腔镜疝修补方法：33例患者采用经腹膜技术加腹膜前吻合器固定补片（经腹腹膜前修补术或TAPP技术），58例患者采用完全腹膜外非吻合器补片放置（完全腹膜外入路或TEPA技术）。转为开放手术的发生率相同（分别为5%和7%），原因是粘连、出血、疝囊内肠袢无法回纳或严重皮下气肿。术后轻微并发症包括局部血清肿或血肿、睾丸疼痛和感觉异常性股痛。无死亡病例，也无长期并发症。平均随访15.8个月（TAPP组）和17.6个月（TEPA组）后，两组的复发率分别为2.7%（TAPP组）和2.8%（TEPA组）。两组均在平均分别为13.6天（TAPP组）和12.9天（TEPA组）后恢复正常活动。结论是，腹腔镜疝修补术的经腹途径和完全腹膜外入路都是腹股沟疝修补的合适技术，并发症和短期复发率相似。
