Is previous radical prostatectomy a contraindication to minimally invasive inguinal hernia repair? A contemporary meta-analysis.

IF 2.6 2区医学 Q1 SURGERY

Hernia Pub Date : 2024-10-01 Epub Date: 2024-07-11 DOI:10.1007/s10029-024-03098-6

Alberto Aiolfi, Davide Bona, Matteo Calì, Michele Manara, Gianluca Bonitta, Marta Cavalli, Piero Giovanni Bruni, Luca Carmignani, Piergiorgio Danelli, Luigi Bonavina, Ferdinand Köckerling, Giampiero Campanelli

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Abstract

Introduction: Traditionally, radical prostatectomy (RP) has been considered a contraindication to minimally invasive inguinal hernia repair. Purpose of this systematic review was to examine the current evidence and outcomes of minimally invasive inguinal hernia repair after RP.

Materials and 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.

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既往根治性前列腺切除术是微创腹股沟疝修补术的禁忌症吗？当代荟萃分析。

导言：传统上，根治性前列腺切除术（RP）被认为是微创腹股沟疝修补术的禁忌症。本系统性综述的目的是研究前列腺癌根治术后微创腹股沟疝修补术的现有证据和结果：查阅了 Web of Science、PubMed 和 EMBASE 数据集。包括腹腔镜经腹腹膜前修补术（TAPP）、机器人TAPP（r-TAPP）和完全腹膜外修补术（TEP）：结果：共纳入了 4655 例（16 项研究）在 RP 术后接受 TAPP、r-TAPP 和 TEP 腹股沟疝修补术的患者。患者年龄从 35 岁到 85 岁不等。描述了开腹（49.1%）、腹腔镜（7.4%）和机器人（43.5%）RP。96.3%的患者进行了原发性单侧疝修补术，2.8%的患者因复发而进行了手术。术中并发症的总发生率为 0.7%（95% CI 0.2-3.4%）。膀胱损伤和上腹部血管出血均有报道。转为开腹手术的总发生率为 0.8%（95% CI 0.3-1.7%）。血清肿、血肿和手术部位感染的总发生率估计分别为 3.2% (95% CI 1.9-5.9%)、1.7% (95% CI 0.9-3.1%)和 0.3% (95% CI = 0.1-0.9%)。中位随访时间为 18 个月（8-48 个月）。疝气复发和慢性疼痛的总发生率分别为1.1%（95% CI 0.1-3.1%）和1.9%（95% CI 0.9-4.1%）：微创腹股沟疝修补术在治疗RP术后腹股沟疝方面似乎是可行、安全和有效的。前列腺切除术不一定是微创腹股沟疝修补术的禁忌症。

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

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.