METHODS: Web of Science, PubMed, and EMBASE data sets were consulted. Laparoscopic transabdominal preperitoneal repair (TAPP), robotic TAPP (r-TAPP), and totally extraperitoneal (TEP) repair were included.
RESULTS: Overall, 4655 patients (16 studies) undergoing TAPP, r-TAPP, and TEP inguinal hernia repair after RP were included. The age of the patients ranged from 35 to 85 years. Open (49.1%), laparoscopic (7.4%), and robotic (43.5%) RP were described. Primary unilateral hernia repair was detailed in 96.3% of patients while 2.8% of patients were operated for recurrence. The pooled prevalence of intraoperative complication was 0.7% (95% CI 0.2-3.4%). Bladder injury and epigastric vessels bleeding were reported. The pooled prevalence of conversion to open was 0.8% (95% CI 0.3-1.7%). The estimated pooled prevalence of seroma, hematoma, and surgical site infection was 3.2% (95% CI 1.9-5.9%), 1.7% (95% CI 0.9-3.1%), and 0.3% (95% CI = 0.1-0.9%), respectively. The median follow-up was 18 months (range 8-48). The pooled prevalence of hernia recurrence and chronic pain were 1.1% (95% CI 0.1-3.1%) and 1.9% (95% CI 0.9-4.1%), respectively.
CONCLUSIONS: Minimally invasive inguinal hernia repair seems feasible, safe, and effective for the treatment of inguinal hernia after RP. Prostatectomy should not be necessarily considered a contraindication to minimally invasive inguinal hernia repair.
方法:WebofScience,PubMed,和EMBASE数据集进行了咨询。腹腔镜经腹腹膜前修补术(TAPP),机器人TAPP(r-TAPP),包括完全腹膜外(TEP)修复。
结果:总体而言,4655名患者(16项研究)接受TAPP,r-TAPP,包括RP后TEP腹股沟疝修补术。患者的年龄范围为35至85岁。开放(49.1%),腹腔镜(7.4%),和机器人(43.5%)RP被描述。96.3%的患者进行了原发性单侧疝修补,而2.8%的患者因复发而手术。术中并发症的合并发生率为0.7%(95%CI0.2-3.4%)。报告膀胱损伤和上腹部血管出血。转换为开放的合并患病率为0.8%(95%CI0.3-1.7%)。血清肿的估计汇总患病率,血肿,手术部位感染为3.2%(95%CI1.9-5.9%),1.7%(95%CI0.9-3.1%),和0.3%(95%CI=0.1-0.9%),分别。中位随访时间为18个月(范围8-48)。疝复发和慢性疼痛的合并患病率为1.1%(95%CI0.1-3.1%)和1.9%(95%CI0.9-4.1%),分别。
结论:微创腹股沟疝修补术似乎是可行的,安全,对RP术后腹股沟疝的治疗有效。前列腺切除术不一定被认为是微创腹股沟疝修补术的禁忌症。