{"title":"腹股沟疝无缝线修补技术:腹腔镜与开放方法的比较。","authors":"Stefano Olmi, Alessandro Delcarro, Francesca Ciccarese, Adelinda Angela Giulia Zanoni, Matteo Uccelli, Giovanni Cesana","doi":"10.1089/lap.2025.0039","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Background:</i></b> The study is designed to compare laparoscopic and anterior sutureless techniques for repairing inguinal hernia. <b><i>Methods:</i></b> For several years, our group has performed both laparoscopic and anterior sutureless inguinal hernia repairs. This retrospective cohort study analyzed 160 patients with inguinal hernias who underwent sutureless surgical alloplasty between July 2018 and July 2019. Eighty patients were treated laparoscopically (transabdominal preperitoneal approach) with a polypropylene mesh secured with fibrin glue (Tisseel®; Baxter Health, Deerfield, IL). The remaining 80 patients underwent open alloplasty using a preformed double-layered polypropylene mesh (Folded-Mesh; Angiologica, Italy) that did not require suture or glue fixation. Clinical follow-up data were collected for a period of 60 months. <b><i>Results:</i></b> The two groups were comparable in terms of age, gender, and ASA score. There was no statistically significant difference in operative time between the laparoscopic and open techniques (34.16 ± 8.50 versus 40.17 ± 7.92 minutes; <i>P</i> > .05). No laparoscopic procedure required conversion to open surgery. No perioperative complications were reported in either group. A significant difference was observed in postoperative neuralgia, with 0 cases in the laparoscopic group versus 8 cases in the open group (<i>P</i> < .05). Persistent pain (lasting more than 6 months) was reported in only 2 patients in the open group (<i>P</i> > .05). Relapse was only observed in the open repair group. <b><i>Conclusions:</i></b> Sutureless inguinal hernia repair is a safe and effective procedure with minimal complications. The laparoscopic approach appears to be superior, offering a faster recovery and fewer postoperative issues, making it the preferred choice for sutureless hernia repair.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"451-457"},"PeriodicalIF":1.1000,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sutureless Inguinal Hernia Repair Techniques: A Comparison Between Laparoscopic and Open Methods.\",\"authors\":\"Stefano Olmi, Alessandro Delcarro, Francesca Ciccarese, Adelinda Angela Giulia Zanoni, Matteo Uccelli, Giovanni Cesana\",\"doi\":\"10.1089/lap.2025.0039\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b><i>Background:</i></b> The study is designed to compare laparoscopic and anterior sutureless techniques for repairing inguinal hernia. <b><i>Methods:</i></b> For several years, our group has performed both laparoscopic and anterior sutureless inguinal hernia repairs. This retrospective cohort study analyzed 160 patients with inguinal hernias who underwent sutureless surgical alloplasty between July 2018 and July 2019. Eighty patients were treated laparoscopically (transabdominal preperitoneal approach) with a polypropylene mesh secured with fibrin glue (Tisseel®; Baxter Health, Deerfield, IL). The remaining 80 patients underwent open alloplasty using a preformed double-layered polypropylene mesh (Folded-Mesh; Angiologica, Italy) that did not require suture or glue fixation. Clinical follow-up data were collected for a period of 60 months. <b><i>Results:</i></b> The two groups were comparable in terms of age, gender, and ASA score. There was no statistically significant difference in operative time between the laparoscopic and open techniques (34.16 ± 8.50 versus 40.17 ± 7.92 minutes; <i>P</i> > .05). No laparoscopic procedure required conversion to open surgery. No perioperative complications were reported in either group. A significant difference was observed in postoperative neuralgia, with 0 cases in the laparoscopic group versus 8 cases in the open group (<i>P</i> < .05). Persistent pain (lasting more than 6 months) was reported in only 2 patients in the open group (<i>P</i> > .05). Relapse was only observed in the open repair group. <b><i>Conclusions:</i></b> Sutureless inguinal hernia repair is a safe and effective procedure with minimal complications. The laparoscopic approach appears to be superior, offering a faster recovery and fewer postoperative issues, making it the preferred choice for sutureless hernia repair.</p>\",\"PeriodicalId\":50166,\"journal\":{\"name\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"volume\":\" \",\"pages\":\"451-457\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Laparoendoscopic & Advanced Surgical Techniques\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1089/lap.2025.0039\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/4/23 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Laparoendoscopic & Advanced Surgical Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/lap.2025.0039","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/23 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景:本研究旨在比较腹腔镜和前路无缝线技术在修补腹股沟疝中的应用。方法:多年来,我们组进行了腹腔镜和前路无缝合修补腹股沟疝。本回顾性队列研究分析了2018年7月至2019年7月期间接受无缝线手术异体成形术的160例腹股沟疝患者。80例患者接受腹腔镜(经腹腹膜前入路)治疗,使用纤维蛋白胶(Tisseel®;巴克斯特健康公司,迪尔菲尔德,伊利诺伊州)。其余80例患者采用预先成形的双层聚丙烯网片(fold - mesh;血管,意大利),不需要缝合或胶固定。临床随访资料收集60个月。结果:两组在年龄、性别和ASA评分方面具有可比性。腹腔镜与开放式手术时间差异无统计学意义(34.16±8.50 min vs 40.17±7.92 min);P < 0.05)。没有腹腔镜手术需要转换为开放手术。两组均无围手术期并发症。两组术后神经痛发生率比较,腹腔镜组0例,开放组8例,差异有统计学意义(P < 0.05)。开放组仅有2例患者出现持续疼痛(持续6个月以上)(P < 0.05)。只有开放修复组复发。结论:腹股沟疝修补术安全有效,并发症少。腹腔镜方法似乎更优越,提供更快的恢复和更少的术后问题,使其成为无缝合线疝修补的首选。
Sutureless Inguinal Hernia Repair Techniques: A Comparison Between Laparoscopic and Open Methods.
Background: The study is designed to compare laparoscopic and anterior sutureless techniques for repairing inguinal hernia. Methods: For several years, our group has performed both laparoscopic and anterior sutureless inguinal hernia repairs. This retrospective cohort study analyzed 160 patients with inguinal hernias who underwent sutureless surgical alloplasty between July 2018 and July 2019. Eighty patients were treated laparoscopically (transabdominal preperitoneal approach) with a polypropylene mesh secured with fibrin glue (Tisseel®; Baxter Health, Deerfield, IL). The remaining 80 patients underwent open alloplasty using a preformed double-layered polypropylene mesh (Folded-Mesh; Angiologica, Italy) that did not require suture or glue fixation. Clinical follow-up data were collected for a period of 60 months. Results: The two groups were comparable in terms of age, gender, and ASA score. There was no statistically significant difference in operative time between the laparoscopic and open techniques (34.16 ± 8.50 versus 40.17 ± 7.92 minutes; P > .05). No laparoscopic procedure required conversion to open surgery. No perioperative complications were reported in either group. A significant difference was observed in postoperative neuralgia, with 0 cases in the laparoscopic group versus 8 cases in the open group (P < .05). Persistent pain (lasting more than 6 months) was reported in only 2 patients in the open group (P > .05). Relapse was only observed in the open repair group. Conclusions: Sutureless inguinal hernia repair is a safe and effective procedure with minimal complications. The laparoscopic approach appears to be superior, offering a faster recovery and fewer postoperative issues, making it the preferred choice for sutureless hernia repair.
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.