背景:女性一生中有3%的机会发生腹股沟疝,这在男人中并不常见。由于其化妆品的好处,单切口腹腔镜经腹腹膜前腹股沟疝修补术(SIL-TAPP)在女性腹股沟疝的治疗中越来越受欢迎。然而,没有研究比较SIL-TAPP修补术与传统腹腔镜经腹腹膜前腹股沟疝修补术(CL-TAPP)治疗女性腹股沟疝的安全性和适用性.
目的:比较SIL-TAPP和CL-TAPP在成年女性腹股沟疝患者中的治疗效果,并评估SIL-TAPP在成年女性腹股沟疝患者中的安全性和适用性。
方法:回顾性比较2018年2月至2020年12月在南通大学附属医院接受SIL-TAPP腹股沟疝修补术的女性腹股沟疝患者和接受CL-TAPP腹股沟疝修补术的女性腹股沟疝患者的临床信息和随访数据,并评估两个队列的长期和短期结局。
结果:这项研究包括123名患者,71例接受SIL-TAPP修复,52例接受CL-TAPP修复。两组患者的腹股沟疝特征相似,没有统计学上有意义的差异。SIL-TAPP组患者术中腹壁下血管损伤率(0,0%)低于CL-TAPP组患者(4,7.7%),差异有统计学意义(P<0.05)。此外,SIL-TAPP队列患者的中位[四分位距(IQR)]总住院费用[$3287(3218-3325)]显著低于CL-TAPP队列患者[$3511(3491-3599)].术后,SIL-TAPP组(0,0%)的套管针疝发生率低于CL-TAPP组(4,7.7%),SIL-TAPP组[10(10-10)]的中位(IQR)美容评分显著高于CL-TAPP组[9(9-10)].
结论:SIL-TAPP修补术并未增加女性腹股沟疝患者术中和术后并发症的发生率。此外,与接受CL-TAPP修补术的女性腹股沟疝患者相比,接受SIL-TAPP修补术的女性腹股沟疝患者发生套管针部位疝和腹壁下血管损伤的概率较低.此外,接受SIL-TAPP修补术的女性腹股沟疝患者报告术后腹部切口更美观.因此,SIL-TAPP修复是治疗女性腹股沟疝的较好选择。
BACKGROUND: Women have a 3% lifetime chance of developing an inguinal hernia, which is not as common in men. Due to its cosmetic benefits, single-incision laparoscopic transabdominal preperitoneal (SIL-TAPP) inguinal hernia repair is becoming increasingly popular in the management of inguinal hernia in women. However, there are no studies comparing the safety and applicability of SIL-TAPP repair with conventional laparoscopic transabdominal preperitoneal (CL-TAPP) inguinal hernia repair for the treatment of inguinal hernia in women.
OBJECTIVE: To compare the outcomes of SIL-TAPP and CL-TAPP repair in adult female patients with inguinal hernia and to estimate the safety and applicability of SIL-TAPP repair in adult female inguinal hernia patients.
METHODS: We retrospectively compared the clinical information and follow-up data of female inguinal hernia patients who underwent SIL-TAPP inguinal hernia repair and those who underwent CL-TAPP inguinal hernia repair at the Affiliated Hospital of Nantong University from February 2018 to December 2020 and assessed the long-term and short-term outcomes of both cohorts.
RESULTS: This study included 123 patients, with 71 undergoing SIL-TAPP repair and 52 undergoing CL-TAPP repair. The two cohorts of patients and inguinal hernia characteristics were similar, with no statistically meaningful difference. The rate of intraoperative inferior epigastric vessel injury was lower in patients in the SIL-TAPP cohort (0, 0%) than in patients in the CL-TAPP cohort (4, 7.7%) and was significantly different (P < 0.05). In addition, the median [interquartile range (IQR)] total hospitalization costs were significantly lower in patients in the SIL-TAPP cohort [$3287 (3218-3325)] than in patients in the CL-TAPP cohort [$3511 (3491-3599)]. Postoperatively, the occurrence rate of trocar site hernia was lower in the SIL-TAPP cohort (0, 0%) than in the CL-TAPP cohort (4, 7.7%), and the median (IQR) cosmetic score was significantly higher in the SIL-TAPP cohort [10 (10-10)] than in the CL-TAPP cohort [9 (9-10)].
CONCLUSIONS: SIL-TAPP repair did not increase the incidence of intraoperative and postoperative complications in female inguinal hernia patients. Moreover, female inguinal hernia patients who underwent SIL-TAPP repair had a lower probability of trocar site hernia and inferior epigastric vessel injury than female inguinal hernia patients who underwent CL-TAPP repair. In addition, female inguinal hernia patients who underwent SIL-TAPP repair reported a more aesthetically pleasing postoperative abdominal incision. Therefore, SIL-TAPP repair is a better option for the treatment of inguinal hernias in women.