Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair
Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair
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DOI：
10.1002/bjs.5405
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发表时间：
2006-09-01
影响因子：
9.6
通讯作者：
Montgomery, A.
中科院分区：
文献类型：
--
作者：
Eklund, A.;Rudberg, C.;Montgomery, A.
背景：腹腔镜腹股沟疝修补术已成为公认的腹股沟疝修补术。这项研究比较了两种无张力修补方法：完全腹膜外(TEP)腹膜外补片修补术和开放Lichstein补片修补技术的短期效果。方法：来自11家医院的1513名男性患者被随机分为两种方法之一。记录手术时间、近期并发症、再次手术、术后疼痛、镇痛剂用量、病假和恢复正常体力活动的时间。结果：1513名男性中有1371人接受了手术，其中TEP组665人，Lichstein组706人。两种术式的中位手术时间均为55min，91.0%的死亡患者在手术当天出院。TEP组患者术后疼痛较少(P<；0.001)，镇痛剂用量较少(P<；0.001)，病假时间较短(7天对12天；P<；0.001)，恢复正常体力活动时间较短(20天对31天；P<；0.001)。结论：与开放腹股沟疝修补术相比，TEP术式操作时间短，术后疼痛轻，病假短，恢复快。
Background: Laparoscopic herniorrhaphy has emerged as a recognized operative method for inguinal hernia repair. This study compared the short-term results of two tension-free methods of repair: totally extraperitoneal (TEP) laparoscopic patch repair and the open Lichtenstein mesh technique.Methods: A total of 1513 men from 11 hospitals who presented with a primary unilateral inguinal hernia were randomized to one of the two methods. Operating time, short-term complications, reoperations, postoperative pain, consumption of analgesics, sick leave and time to resumption of normal physical activities were recorded.Results: Some 1371 of the 1513 men underwent surgery, 665 in the TEP group and 706 in the Lichtenstein group. The median duration of operation was 55 min for both procedures and 91.0 per cent of die patients in both groups were discharged on the day of operation. Patients in the TEP group experienced less postoperative pain (P < 0.001), consumed fewer analgesics (P < 0.001), had a shorter period of sick leave (7 versus 12 days; P < 0.001) and a shorter time to resumption of normal physical activity (20 versus 31 days; P < 0.001).Conclusion: The TEP technique took no longer to perform, and was associated with less postoperative pain, a shorter period of sick leave and a faster recovery, compared with open Lichtenstein hernia repair.