Τίτλος:
Comparison of laparoscopic and open tension-free repair of recurrent
inguinal hernias: a prospective randomized study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: The current prospective randomized controlled clinical study
aimed to assess the short- and long-term results of recurrent inguinal
hernia repair, and to compare the results for transabdominal
preperitoneal (TAPP) and totally extraperitoneal (TEP) procedures with
those for open tension-free repair.
Methods: For this study. 82 patients were randomly assigned to undergo
TAPP (group A, n = 24), TEP (group B, n = 26), or open Lichtenstein
hernioplasty (group C, n = 32). All the patients with recurrent inguinal
hernias had undergone previous repair using conventional open
procedures. Physical examination showed Nyhus type II hernia in the vast
majority of the patients (59%). High-risk patients (American Society of
Anesthesiology [ASA] III or IV); coagulation disorders; previous
abdominal or pelvic surgery; and irreducible, congenital, and massive
scrotal or sliding hernias were excluded from the study.
Results: There was a statistically significant difference (p = 0.001) in
operating time favoring the open procedure. The intensity of
postoperative pain was greater in the open hernia repair group 24 h, 48
h, and 7 days after surgery (p = 0.001), with a greater consumption of
pain medication among these patients (p < 0.004). The median time until
return to work was 14 days for group A, 13 days for Group g, and 20 days
for group C. The comparison was in favor of laparoscopically treated
patients. Nine recurrences (4 in the laparoscopic groups and 5 in the
open group) were documented within 3 years of follow-up evaluation.
Conclusion: Laparoscopic inguinal hernia repair (TAPP or TEP) is the
method of choice for dealing with recurrent inguinal hernia.
Συγγραφείς:
Dedemadi, G.
Sgourakis, G.
Karaliotas, C.
Christofides, T.
and Kouraklis, G.
Karaliotas, C.
Περιοδικό:
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
Λέξεις-κλειδιά:
inguinal hernia repair; laparoscopic repair; TAPP; tension-free repair;
TEP; totally extraperitoneal; transabdominal preperitoneal; recurrence
DOI:
10.1007/s00464-005-0621-8
