目的:Lichtenstein疝修补术一直被视为腹股沟疝修补术的金标准。不幸的是,这种修复通常与慢性疼痛有关,高达10-35%。因此,已经开发了几种新技术,例如经腹股沟腹膜前补片(TIPP)和内窥镜全腹膜外(TEP)技术。一些研究表明,与Lichtenstein疝修补术相比,TIPP和TEP的有益结果;然而,在比较TIPP和TEP程序时,几乎没有公布结果。本研究旨在评估TIPP与TEP技术腹股沟疝修补术后的结果。
方法:在2015年至2020年之间进行了一项单中心随机对照试验。共纳入300例单侧腹股沟疝患者,并随机接受TIPP或TEP技术。主要结果是慢性疼痛(定义为最后3个月后的任何疼痛)和生活质量,在12个月时使用卡罗莱纳州舒适量表(CCS)进行评估。次要结果是:伤口感染,伤口感觉减退,复发,30天内重新接纳,再操作。
结果:共300例患者被随机分组(每组150例)。经过12个月的随访,我们观察到术后慢性腹股沟疼痛明显减少,劳累时的慢性疼痛,伤口感觉减退,与TIPP程序相比,TEP后的伤口感染。生活质量无显著差异,重新操作,复发率,并观察到30天内再入院。
结论:我们表明,与TIPP程序相比,TEP程序具有良好的结果,减少术后疼痛和伤口并发症,而两组的复发率和再手术率相等.
The Lichtenstein hernioplasty has long been seen as the gold standard for inguinal hernia repair. Unfortunately, this repair is often associated with chronic pain, up to 10-35%. Therefore, several new techniques have been developed, such as the transinguinal preperitoneal patch (TIPP) and the endoscopic total extraperitoneal (TEP) technique. Several studies showed beneficial results of the TIPP and
TEP compared to the Lichtenstein hernioplasty; however, little is published on the outcome when comparing the TIPP and
TEP procedures. This
study aimed to evaluate outcomes after the TIPP vs the
TEP technique for inguinal hernia repair.
A single-center randomized controlled
trial was carried out between 2015 and 2020. A total of 300 patients with unilateral inguinal hernia were enrolled and randomized to the TIPP- or
TEP technique. Primary outcome was chronic pain (defined as any pain following the last 3 months) and quality of life, assessed with Carolinas comfort scale (CCS) at 12 months. Secondary outcomes were: wound infection, wound hypoesthesia, recurrence, readmission within 30 days, and reoperation.
A total of 300 patients were randomized (150 per group). After a follow-up of 12 months, we observed significantly less postoperative chronic groin pain, chronic pain at exertion, wound hypoesthesia, and wound infections after the TEP when compared to the TIPP procedure. No significant differences in quality of life, reoperations, recurrence rate, and readmission within 30 days were observed.
We showed that the TEP has a favorable outcome compared to the TIPP procedure, leading to less postoperative pain and wound complications, whereas recurrence rates and reoperations were equal in both the groups.