Surgical Procedures and Results of Modified Intraperitoneal Onlay Mesh Repair for Inguinal Hernia After Radical Prostatectomy
Surgical Procedures and Results of Modified Intraperitoneal Onlay Mesh Repair for Inguinal Hernia After Radical Prostatectomy
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DOI：
10.1089/lap.2020.0141
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发表时间：
2020-04-24
影响因子：
1.3
通讯作者：
Ishizaki, Yoichi
中科院分区：
文献类型：
--
作者：
Ohuchi, Masakazu;Inaki, Noriyuki;Ishizaki, Yoichi
背景资料：虽然腹股沟疝经常发生在根治性直肠癌切除术后，但由于腹膜前腔纤维化，经腹腹膜前（TAPP）腹股沟疝修补术偶尔会带来挑战。对于严重盆腔纤维化的患者，我们采用了改良的腹膜内补片（IPOM）技术。手术因素进行了比较谁接受了改良IPOM和那些谁接受TAPP腹股沟疝repair.Materials和方法：在2013年2月至2020年1月期间，共57例患者接受腹腔镜手术根治性腹股沟疝切除术后。44例患者成功完成了TAPP，而13例患者接受了TAPP转换的改良IPOM。结果：随访1-84个月，中位时间36.0个月。两组均未观察到术中并发症、疝复发和慢性疼痛。改良IPOM组的平均手术时间长于TAPP组（137 vs 107分钟，P <0.05）。腹股沟相关并发症如腹股沟疼痛或腹股沟肿胀的发生率无显著差异。结论：改良IPOM后的术后并发症，包括疝复发与TAPP疝修补术后的并发症相当。改良IPOM修补术是根治性腹股沟疝切除术后修补腹股沟疝的一种手术选择。
Background: Although inguinal hernia occurs frequently after radical prostatectomy, transabdominal preperitoneal (TAPP) inguinal hernia repair occasionally poses challenges due to fibrosis of the preperitoneal cavity. In patients with severe intrapelvic fibrosis, we have adopted a modified intraperitoneal onlay mesh (IPOM) technique. The surgical factors were compared between patients who underwent modified IPOM and those who underwent TAPP for inguinal hernia repair.Materials and Methods: In total, 57 patients underwent laparoscopic surgery for inguinal hernias after radical prostatectomy between February 2013 and January 2020. TAPP was successfully completed in 44 patients, whereas 13 patients underwent modified IPOM converted from TAPP. The surgical results were retrospectively compared.Results: The median follow-up duration was 36.0 months (range, 1-84 months). Intraoperative complications, recurrence of hernia, and chronic pain were not observed in both groups. The average duration of surgery in the modified IPOM group was longer than that in the TAPP group (137 versus 107 minutes, P < .05). There was no significant difference in the incidence of the inguinal-related complications such as inguinal pain or inguinal swelling.Conclusions: Postoperative complications including recurrence of hernia after modified IPOM are comparable to those after TAPP hernia repair. Modified IPOM repair is a surgical option for repairing inguinal hernias following radical prostatectomy.