腹腔镜经腹腹膜前和全腹膜外技术在腹股沟疝手术中的应用:两种技术术中及术后早期并发症的比较

A. Yıldız
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引用次数: 6

摘要

目的完全腹膜外(TEP)和经腹腹膜前(TAPP)是腹股沟疝手术中常用的腹腔镜技术。很少有研究直接比较TEP和TAPP的疗效。本研究比较了两种技术的技术方面、术中和术后早期并发症。方法在2016年5月至2020年12月期间,108例诊断为腹股沟疝的患者接受了腹腔镜手术。76例(70.4%)行TEP, 32例(29.6%)行TAPP。本研究为回顾性研究。然而,数据是前瞻性登记的(包括录像)。结果两组患者在年龄、性别、体重指数、美国麻醉医师身体状态分类、住院时间等方面均无显著差异。虽然TEP组的总并发症发生率高于TAPP组,但两组间差异无统计学意义(TEP为9.2%,TAPP为3.1%,p = 0.979)。在TEP中观察到2例转化和2例复发(各2.6%)。两种方法均出现1例血肿(3.1% vs. 1.3%, p = 0.665)。TEP组1例患者出现假性动脉瘤并行血管内栓塞治疗。结论在本组研究中,TEP术中转换及术后早期并发症较TAPP多见。另一方面,两种技术的结果之间没有明显差异。发现TAPP在腹股沟疝手术中与TEP一样安全;然而,在本研究中没有观察到一种方法优于另一种方法。
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Laparoscopic transabdominal preperitoneal and totally extraperitoneal in inguinal hernia surgery: comparison of intraoperative and postoperative early complications of two techniques
Purpose Totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) are laparoscopic techniques frequently used in inguinal hernia surgeries. There are very few studies directly comparing the outcomes of TEP and TAPP. The present study compared both techniques’ technical aspects, intraoperative and postoperative early complications. Methods In this study, 108 patients diagnosed with inguinal hernia underwent laparoscopic surgery between May 2016 and December 2020. Seventy six of these patients (70.4%) underwent TEP, and 32 (29.6%) underwent TAPP. This study was retrospective. However, the data were registered prospectively (including video recordings). Results No significant difference was found between the groups regarding age, sex, body mass index, American Society of Anesthesiologist physical status classification, and duration of hospitalization. Although the TEP group had a higher overall complication rate than TAPP, the difference between the two groups was not significant (TEP, 9.2% vs. TAPP, 3.1%, p = 0.979). Two conversions and two recurrences (2.6% each) were observed in TEP. The hematoma was seen in one case in both techniques (3.1% vs. 1.3%, p = 0.665), respectively. A patient in the TEP group developed a pseudoaneurysm and was treated with endovascular embolization. Conclusion In our study, conversion and intraoperative early postoperative complications were more prevalent in TEP than TAPP. On the other hand, no significant difference was determined between the results of the two techniques. It has been found that TAPP is as safe as TEP in inguinal hernia surgery; however, the superiority of one method over the other was not observed in this study.
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