Total Ekstraperitoneal Kasık Fıtığı Onarımında Teleskopik ve Balon Diseksiyon Tekniklerinin Karşılaştırılması: Retrospektif Bir Analiz

Yıl 2025, Cilt: 6 Sayı: 2, 88 - 92, 20.05.2025

Emre Teke , Sibel Yaman

https://doi.org/10.47482/acmr.1606955

Öz

Giriş: Total ekstraperitoneal (TEP) fıtık onarımı, balon veya teleskopik diseksiyon (TD) ile preperitoneal bir boşluk oluşturmayı içerir. Bu çalışma, erkek hastalarda TEP kasık fıtığı onarımında TD ve BD tekniklerinin sonuçlarını karşılaştırmayı amaçlamaktadır.
Yöntemler: Kasım 2023 ile Kasım 2024 arasında tek bir cerrah tarafından TEP fıtığı onarımı geçiren erkek hastalar üzerinde retrospektif bir analiz yürütülmüştür. Hastalar preperitoneal boşluğu oluşturmak için kullanılan tekniğe göre iki gruba ayrılmıştır: BD veya TD. Demografik veriler, ameliyat sonuçları ve ameliyat sonrası ağrı skorları gruplar arasında karşılaştırılmıştır. İstatistiksel anlamlılık P < 0,05 olarak belirlenmiştir.
Bulgular: Toplam 49 hasta dahil edilmiştir; 31'i TD grubunda ve 18'i BD grubundadır. BD grubunun ameliyat süreleri önemli ölçüde daha kısaydı (37,8 ± 15,8'e karşı 45,6 ± 17,4 dakika, P = 0,029). Ameliyat sonrası ağrı 3. saatte TD grubunda önemli ölçüde daha düşüktü (2,0 ± 2,1'e karşı 3,0 ± 1,6, P = 0,018). Daha sonraki zaman noktalarındaki ağrı skorları ve periton yırtığı oranları ve hastanede kalış süresi gibi diğer parametreler gruplar arasında benzerdi.
Sonuç: Hem TD hem de BD, TEP herni onarımı için güvenli ve etkili tekniklerdir. BD ameliyat süresini azaltabilirken, TD üstün erken ameliyat sonrası ağrı kontrolü sunar. Teknik seçimi hasta özellikleri, cerrahın uzmanlığı ve maliyet hususları tarafından yönlendirilmelidir.

Anahtar Kelimeler

total ekstraperitoneal fıtık onarımı, teleskopik diseksiyon, balon diseksiyon, postoperatif ağrı

Comparison of Telescopic and Balloon Dissection Techniques in Total Extraperitoneal Inguinal Hernia Repair: A Retrospective Analysis

Öz

Background: Totally extraperitoneal (TEP) repair involves creating a preperitoneal space with balloon or telescopic dissection (TD). This study aimed to compare the outcomes of TD and BD techniques in TEP inguinal hernia repair in male patients.
Methods: A retrospective analysis was conducted on male patients who underwent TEP hernia repair by a single surgeon between November 2023 and November 2024. Patients were divided into two groups based on the technique used to create the preperitoneal space: BD or TD. Demographic data, operative outcomes, and postoperative pain scores were compared between the groups. Statistical significance was set at P < 0.05.
Results: A total of 49 patients were included, with 31 in the TD group and 18 in the BD group. The BD group had significantly shorter operative times (37.8 ± 15.8 vs. 45.6 ± 17.4 minutes, P = 0.029). Postoperative pain at the 3rd hour was significantly lower in the TD group (2.0 ± 2.1 vs. 3.0 ± 1.6, P = 0.018). Pain scores at later time points and other parameters, including peritoneal rupture rates and hospital stay duration, were comparable between the groups.
Conclusion: Both TD and BD are safe and effective techniques for TEP hernia repair. BD may reduce operative time, while TD offers superior early postoperative pain control. The choice of technique should be guided by patient characteristics, surgeon expertise, and cost considerations.

Anahtar Kelimeler

Total Extraperitoneal Hernia Repair, Balloon Dissection, Telescopic Dissection, Postoperative Pain

Kaynakça

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