PDF(Pubmed)
Abstract：
Although there have been numerous studies on single-incision laparoscopic inguinal hernia repair (SIL-IHR), the short- and long-term outcomes in patients from a large single institution who underwent single-incision laparoscopic transabdominal preperitoneal hernioplasty (SIL-TAPP) have rarely been reported. The purpose of this study is to evaluate the short- and long-term outcomes of SIL-TAPP and its safety and feasibility in patients from a large single institution.
The details of 1,054 procedures in 966 patients who underwent SIL-TAPP at the Affiliated Hospital of Nantong University from January 2015 to October 2022 were retrospectively analysed. SIL-TAPP was performed completely through the umbilicus using conventional laparoscopic instruments. Short-term and long-term outcomes of SIL-TAPP were collected by outpatient and telephone follow-ups. In addition, we further compared the operation time, length of postoperative hospital stay, and postoperative complications of patients with simple and complicated unilateral inguinal hernias.
A total of 1,054 procedures were performed for 878 unilateral inguinal hernias and 88 bilateral inguinal hernias. In total, there were 803 (76.2%) indirect inguinal hernias, 192 (18.2%) direct inguinal hernias, 51 (4.8%) femoral hernias and 8 (0.8%) combined hernias. The mean operative time was 35.5 ± 17.0 min for unilateral inguinal hernias and 51.9 ± 25.5 min for bilateral inguinal hernias. There was one (0.1%) conversion to two-incision laparoscopic transabdominal preperitoneal hernioplasty. No intraoperative haemorrhages, inferior epigastric vessel injury or nerve damage occurred. Postoperative complications were minor and could be resolved without surgical intervention. The mean length of hospital stay was 1.3 ± 0.8 days. The median follow-up was 44 months, no trocar hernia occurred, and there was one (0.1%) recurrence. The operation time in the complicated inguinal hernia group was significantly higher than that in the simple inguinal hernia group (38.9 ± 22.3 vs. 35.0 ± 15.6, p = 0.025). The length of postoperative hospital stay and complication rate of the complicated inguinal hernia group were slightly higher than those of the simple inguinal hernia group, but the difference was not statistically significant.
SIL-TAPP is safe and technically feasible, and both short- and long-term outcomes are acceptable.
The details of 1,054 procedures in 966 patients who underwent SIL-TAPP at the Affiliated Hospital of Nantong University from January 2015 to October 2022 were retrospectively analysed. SIL-TAPP was performed completely through the umbilicus using conventional laparoscopic instruments. Short-term and long-term outcomes of SIL-TAPP were collected by outpatient and telephone follow-ups. In addition, we further compared the operation time, length of postoperative hospital stay, and postoperative complications of patients with simple and complicated unilateral inguinal hernias.
A total of 1,054 procedures were performed for 878 unilateral inguinal hernias and 88 bilateral inguinal hernias. In total, there were 803 (76.2%) indirect inguinal hernias, 192 (18.2%) direct inguinal hernias, 51 (4.8%) femoral hernias and 8 (0.8%) combined hernias. The mean operative time was 35.5 ± 17.0 min for unilateral inguinal hernias and 51.9 ± 25.5 min for bilateral inguinal hernias. There was one (0.1%) conversion to two-incision laparoscopic transabdominal preperitoneal hernioplasty. No intraoperative haemorrhages, inferior epigastric vessel injury or nerve damage occurred. Postoperative complications were minor and could be resolved without surgical intervention. The mean length of hospital stay was 1.3 ± 0.8 days. The median follow-up was 44 months, no trocar hernia occurred, and there was one (0.1%) recurrence. The operation time in the complicated inguinal hernia group was significantly higher than that in the simple inguinal hernia group (38.9 ± 22.3 vs. 35.0 ± 15.6, p = 0.025). The length of postoperative hospital stay and complication rate of the complicated inguinal hernia group were slightly higher than those of the simple inguinal hernia group, but the difference was not statistically significant.
SIL-TAPP is safe and technically feasible, and both short- and long-term outcomes are acceptable.
摘要：
目的：尽管已经有许多关于单切口腹腔镜腹股沟疝修补术（SIL-IHR）的研究，在大型单一机构接受单切口腹腔镜经腹腹膜前疝修补术(SIL-TAPP)的患者中,短期和长期结局的报道很少.这项研究的目的是评估SIL-TAPP的短期和长期结果及其在大型单一机构患者中的安全性和可行性。
方法：回顾性分析2015年1月至2022年10月南通大学附属医院966例SIL-TAPP患者的1,054例手术详情。使用常规腹腔镜器械完全通过脐部进行SIL-TAPP。通过门诊和电话随访收集SIL-TAPP的短期和长期结果。此外,我们进一步比较了手术时间，术后住院时间,单纯性和复杂性单侧腹股沟疝患者的术后并发症。
结果：共对878例单侧腹股沟疝和88例双侧腹股沟疝进行了1,054例手术。总的来说,有803例（76.2%）间接腹股沟疝，192例（18.2%）腹股沟直疝，51例（4.8％）股疝和8例（0.8％）合并疝。单侧腹股沟疝的平均手术时间为35.5±17.0分钟，双侧腹股沟疝的平均手术时间为51.9±25.5分钟。有1例（0.1％）转换为双切口腹腔镜经腹腹膜前疝修补术。术中没有出血,发生腹壁下血管损伤或神经损伤。术后并发症较小，无需手术干预即可解决。平均住院时间为1.3±0.8天。中位随访时间为44个月,没有发生套管针疝,有1例（0.1%）复发。复杂腹股沟疝组手术时间明显高于单纯腹股沟疝组(38.9±22.3vs.35.0±15.6，p=0.025）。复杂性腹股沟疝组术后住院时间和并发症发生率略高于单纯腹股沟疝组,但差异无统计学意义。
结论：SIL-TAPP是安全和技术上可行的，短期和长期结果都是可以接受的。
方法：回顾性分析2015年1月至2022年10月南通大学附属医院966例SIL-TAPP患者的1,054例手术详情。使用常规腹腔镜器械完全通过脐部进行SIL-TAPP。通过门诊和电话随访收集SIL-TAPP的短期和长期结果。此外,我们进一步比较了手术时间，术后住院时间,单纯性和复杂性单侧腹股沟疝患者的术后并发症。
结果：共对878例单侧腹股沟疝和88例双侧腹股沟疝进行了1,054例手术。总的来说,有803例（76.2%）间接腹股沟疝，192例（18.2%）腹股沟直疝，51例（4.8％）股疝和8例（0.8％）合并疝。单侧腹股沟疝的平均手术时间为35.5±17.0分钟，双侧腹股沟疝的平均手术时间为51.9±25.5分钟。有1例（0.1％）转换为双切口腹腔镜经腹腹膜前疝修补术。术中没有出血,发生腹壁下血管损伤或神经损伤。术后并发症较小，无需手术干预即可解决。平均住院时间为1.3±0.8天。中位随访时间为44个月,没有发生套管针疝,有1例（0.1%）复发。复杂腹股沟疝组手术时间明显高于单纯腹股沟疝组(38.9±22.3vs.35.0±15.6，p=0.025）。复杂性腹股沟疝组术后住院时间和并发症发生率略高于单纯腹股沟疝组,但差异无统计学意义。
结论：SIL-TAPP是安全和技术上可行的，短期和长期结果都是可以接受的。
