Laparoscopic transperitoneal inguinal hernia repair (TAPP) after radical prostatectomy: is it safe? Results of prospectively collected data of more than 200 cases
Laparoscopic transperitoneal inguinal hernia repair (TAPP) after radical prostatectomy: is it safe? Results of prospectively collected data of more than 200 cases
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DOI：
10.1007/s00464-008-0291-4
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发表时间：
2009-05-01
影响因子：
3.1
通讯作者：
Bittner, Reinhard
中科院分区：
文献类型：
--
作者：
Wauschkuhn, Constantin Aurel;Schwarz, Jochen;Bittner, Reinhard
腹腔镜经腹膜腹股沟疝修补术（TAPP）在原发性疝中的可行性已经得到了很好的证实，但是TAPP是否也可以推荐用于根治性腹股沟疝切除术后？我们回顾了从1996年3月至2006年12月前瞻性收集的患者数据库，以比较264例腹膜后切除术后TAPP与10，962例原发性疝TAPP的手术数据和术后结局。将直肠癌切除术后的患者分为两组，（手术年份1996年3月至2002年7月和2002年8月至2006年12月，每组132例TAP），以检查可能的学习曲线。（70 vs. 59岁），手术持续时间更长（59对40分钟）和发病率较高（5.7对2.8%），但复发率相似（0.8对0.7%），体重指数（BMI）（25 kg/m2）。亚组分析显示，一个清晰的学习曲线，发病率（9.8-1.5%）和复发率（1.5-0%）下降，但手术时间（60和58分钟）的结果相似。即使根治性直肠癌切除术后TAPP是一个困难的手术，它可以有效和安全地进行。然而，关于复发率的明确决定必须等待长期结果。
Feasibility of laparoscopic transperitoneal inguinal hernia repair (TAPP) in primary hernias has been well established, but can the TAPP also be recommended after radical prostatectomy?Our prospectively collected patient database was reviewed from March 1996 until December 2006 in order to compare operative data and postoperative outcomes in 264 TAPPs after prostatectomy with 10,962 TAPPs because of primary hernias. Patients operated after prostatectomy were divided into two subgroups (year of surgery March 1996-July 2002 and August 2002-December 2006, with 132 TAPPs per group) to check for a possible learning curve.In the group operated after prostatectomy patients were older (70 vs. 59 years), duration of operation was longer (59 vs. 40 min) and morbidity was higher (5.7 vs. 2.8%), but recurrence rate was similar (0.8 vs. 0.7%) as was body mass index (BMI) (25 kg/m(2)). Subgroup analysis showed a clear learning curve with a decrease of morbidity (9.8-1.5%) and recurrence rate (1.5-0%) but similar results in operation time (60 and 58 min).Even if TAPP after radical prostatectomy is a difficult operation it can be performed efficiently and safely. However, for a definite decision regarding recurrence rate long-term results have to be waited for.