Krähenbühl L, Schäfer M, Schilling M, Kuzinkovas V, Büchler M W
Department of Visceral and Transplantation Surgery, Inselspital, University of Bern, Switzerland.
Surg Laparosc Endosc. 1998 Aug;8(4):313-8.
A persistent problem in hernia surgery concerns the repair of bilateral inguinal hernias. A retrospective analysis of 78 patients with bilateral inguinal hernias was performed. Hernia repair was performed either by an open anterior access (modified Shouldice repair) or a laparoscopic posterior approach (TAPP repair). The two patient groups were similar with regard to ASA classification, age, and sex. The intraoperative complication rate was low (2.6% to 7.8%), whereas postoperative complications occurred more frequently (7.7% to 15.4%). The recurrence rate was low in both groups: 5.1% for the open group and 1.3% for the laparoscopic group. The mean hospital stay was 4 days for both groups, and the mean off-work times were 56.4 days and 17.9 days for the open and laparoscopic group, respectively (p < 0.05). Both procedures gave satisfactory results. The main advantages of the laparoscopic approach are the shorter convalescence time and quicker return to work.
疝修补手术中一个长期存在的问题涉及双侧腹股沟疝的修复。对78例双侧腹股沟疝患者进行了回顾性分析。疝修补术采用开放前路(改良Shouldice修补术)或腹腔镜后路(TAPP修补术)进行。两组患者在ASA分级、年龄和性别方面相似。术中并发症发生率较低(2.6%至7.8%),而术后并发症发生频率更高(7.7%至15.4%)。两组的复发率均较低:开放组为5.1%,腹腔镜组为1.3%。两组的平均住院时间均为4天,开放组和腹腔镜组的平均误工时间分别为56.4天和17.9天(p<0.05)。两种手术均取得了满意的效果。腹腔镜手术方法的主要优点是恢复期较短,恢复工作较快。