Abstract：
A retrospective cohort study of patients undergoing laparoscopic inguinal hernia repair compared short- and long-term outcomes between individuals with or without history of previous abdominopelvic surgery, aiming to determine the feasibility of totally extraperitoneal (TEP) repair within this population. All patients who underwent elective TEP inguinal hernia repair by one consultant surgeon across three London hospitals from January 2017 to May 2023 were retrospectively analysed to assess perioperative outcomes. Two hundred sixty-two patients were identified, of whom two hundred forty-three (93%) underwent laparoscopic TEP repair. The most frequent complications were haematoma (6.2%) and seroma (4.1%). Recurrence occurred in four cases (1.6% of operations, 1.1% of hernias). One hundred eighty-four patients (76%) underwent day-case surgery. There were no mesh infections or explanations, vascular or visceral injuries, port-site hernias, damage to testicle, or persisting numbness. There were no requirements for blood transfusion, returns to theatre, or readmissions within 30 days. There was one conversion to open and one death within 60 days of surgery. Eighty-three (34%) had a history of previous AP surgery. There was no significant difference in perioperative outcomes between the AP and non-AP arms. This finding carried true for subgroup analysis of 44 patients whose AP surgical history did not include previous inguinal hernia repair and for those undergoing repair of recurrent hernia. In expert hands, laparoscopic TEP repair is associated with excellent outcomes and low rates of long-term complications, and thus should be considered as standard for patients regardless of a history of AP surgery.
摘要：
一项对接受腹腔镜腹股沟疝修补术的患者进行回顾性队列研究，比较有或没有腹骨盆手术史的个体的短期和长期结果。旨在确定该人群中完全腹膜外（TEP）修复的可行性。对2017年1月至2023年5月伦敦三家医院的一名顾问外科医生进行选择性TEP腹股沟疝修补术的所有患者进行回顾性分析，以评估围手术期结果。确认了两百六十二名患者，其中240例(93%)接受了腹腔镜TEP修复。最常见的并发症是血肿（6.2％）和血清肿（4.1％）。复发发生在4例(1.6%的手术,疝的1.1％）。一百八十四名患者（76％）接受了日间手术。没有网状感染或解释，血管或内脏损伤，港口疝,睾丸损伤,或坚持麻木。没有输血要求,回到剧院，或在30天内重新入院。手术后60天内有1例转为开放，1例死亡。83例（34%）有既往AP手术史。AP和非AP组之间的围手术期结局没有显着差异。这一发现适用于44例AP手术史不包括既往腹股沟疝修补术和接受复发性疝修补术的患者的亚组分析。在专家手中,腹腔镜TEP修复具有良好的预后和较低的长期并发症发生率。因此，无论是否有AP手术史，都应将其视为患者的标准。
