Modified Open Anterior Preperitoneal Repair.

IF 1.4 4区医学 Q3 SURGERY

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2023-10-01 DOI:10.4293/JSLS.2023.00044

Rajeev Sinha, Albail S Yadav, Yasharth Sharma, Swarnava Chanda, Om Kumar Sharma, Nalin Srivastava

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引用次数: 0

Abstract

Background and objectives: Modified anterior preperitoneal (mAPP) repair for inguinal hernia (IH) was compared with Lichtenstein repair (LR) and laparoscopic transabdominal preperitoneal (TAPP) repairs.

Methods: IH patients, after exclusions and subsequent matching for age, type, and extent of hernia, were assigned randomly for mAPP, LR or TAPP repair. The same surgical team performed all operations. Data of predefined endpoints for all the three groups were statistically compared.

Results: One hundred thirty-five patients underwent mAPP, 91 patients LR, and 181 patients TAPP. The operating time for both unilateral and bilateral hernias in the mAPP group was significantly shorter than in LR and TAPP groups. mAPP patients were discharged in significantly less time than LR patients but later than TAPP patients. Postoperative visual analog scale (VAS) score at 24 hours in the mAPP patients was significantly less than LR but at 48 hours the difference was equivocal. But VAS score after mAPP at 24 and 48 hrs was more than in TAPP patients. However, the pain score across all the three groups was similar at 7 days. There was no surgical site infection (SSI) or mesh infection in any patient. Chronic postoperative inguinal pain was seen less often after mAPP than after LR but was least in TAPP patients. Recurrence across all the three groups was not much different.

Conclusion: mAPP appears to be a better choice for open IH repair than LR and matches the advantages of Laparoscopic repairs.

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改良开放式前腹膜前修补术。

背景与目的:比较改良前腹膜前(mAPP)修复腹股沟疝(IH)与Lichtenstein修复(LR)和腹腔镜经腹腹膜前(TAPP)修复。方法:IH患者在排除后，根据年龄、类型和疝程度进行匹配，随机分配进行mAPP、LR或TAPP修复。所有的手术都由同一个手术小组完成。对三组患者的预定终点数据进行统计学比较。结果:135例患者行mAPP, 91例行LR, 181例行TAPP。mAPP组单侧和双侧疝的手术时间均明显短于LR和TAPP组。mAPP患者出院时间明显短于LR患者，但晚于TAPP患者。mAPP患者术后24小时视觉模拟评分(VAS)明显低于LR，但48小时差异不明显。但mAPP术后24、48小时VAS评分高于TAPP患者。然而，所有三组的疼痛评分在7天时相似。所有患者无手术部位感染(SSI)或补片感染。术后慢性腹股沟疼痛在mAPP患者中较少见，但在TAPP患者中最少。三组患者的复发率差别不大。结论:mAPP是开放性IH修复较LR更好的选择，符合腹腔镜修复的优点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JSLS : Journal of the Society of Laparoendoscopic Surgeons SURGERY-

CiteScore

2.40

自引率

0.00%

发文量

审稿时长

4-8 weeks

期刊介绍： JSLS, Journal of the Society of Laparoscopic & Robotic Surgeons publishes original scientific articles on basic science and technical topics in all the fields involved with laparoscopic, robotic, and minimally invasive surgery. CRSLS, MIS Case Reports from SLS is dedicated to the publication of Case Reports in the field of minimally invasive surgery. The journals seek to advance our understandings and practice of minimally invasive, image-guided surgery by providing a forum for all relevant disciplines and by promoting the exchange of information and ideas across specialties.