以前的下腹部手术是否会阻止腹腔镜疝修补术(完全腹膜外或经腹膜前)?前瞻性观察研究。

IF 1.1 4区 医学 Q3 SURGERY
Nevin Sakoglu, Turgut Donmez
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引用次数: 0

摘要

目的:直到最近,完全腹膜外(TEP)手术一直被认为是下腹部手术患者的禁忌症。然而,在最近的手术中,有报道称在这些病例中可以安全地进行 TEP 手术。本研究的目的是探讨腹腔镜疝修补术在接受过和未接受过下腹部手术的患者中的有效性。患者和方法:本研究是一项前瞻性观察研究,时间为 2018 年 5 月至 2023 年 5 月。研究共纳入 288 名患者。所有患者均采用 TEP 技术开始手术。患者分为两组,之前未接受过腹部手术的患者(n = 216)(第一组)和接受过手术的患者(n = 72)(第二组)。确定了患者的人口统计学特征、术中和术后并发症。除描述性统计方法(均值、标准差)外,还使用了 Shapiro-Wilk 正态性检验、独立 t 检验和卡方检验来评估数据。为确定影响既往手术和腹膜撕裂的因素,进行了逻辑回归分析。结果以 P < .05 为显著性水平。结果259 名患者采用 TEP 法进行了手术。第一组的 9 名患者和第二组的 20 名患者将 TEP 法改为经腹腹膜前 (TAPP)。记录了术中和术后并发症。结论:随着腹腔镜疝气手术经验的不断增加,现在已经可以为之前接受过下腹部手术的患者实施腹膜前(TEP)和腹腔入路(TAPP)疝气手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Does Prior Lower Abdominal Surgery Prevent Laparoscopic Hernia Repair (Totally Extraperitoneal or Transabdominal Preperitoneal)? A Prospective Observational Study.

Objective: Totally extraperitoneal (TEP) surgeries were considered contraindicated in patients who underwent lower abdominal surgery until recently. However, in recent surgeries, it has been reported that they can be performed safely in those cases. Our aim in this study is to investigate the effectiveness of laparoscopic hernia repair methods in patients who have and have not had lower abdominal surgery before. Patients and Method: This study was a prospective observational study between May 2018 and May 2023. Two hundred eighty-eight patients were included in the study. The operation was started with the TEP technique in all patients. Patients, classified in two groups who had not previously undergone abdominal surgery (n = 216) (Group I) and who had surgery (n = 72) (Group II). Demographic characteristics of patients, intraoperative and postoperative complications were determined. In addition to descriptive statistical methods (mean, standard deviation), Shapiro-Wilk normality test, independent t test, and chi-square test were used to evaluate the data. Logistic regression analysis was performed to determine the factors affecting the presence of Previous Surgery and Peritoneal Tear. Results were evaluated at the significance level of P < .05. Results: Two hundred fifty-nine patients were operated with TEP method. TEP method was converted to transabdominal preperitoneal (TAPP) in 9 patients from Group I and 20 patients from Group II. Intraoperative and postoperative complications were recorded. Conclusion: With increasing experience in laparoscopic hernia surgery, it is now possible to perform hernia surgeries with preperitoneal (TEP) and abdominal approaches (TAPP) in patients who have previously undergone lower abdominal surgery.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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