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Laparoskopik Total Ekstraperitoneal Herniorafi veya Lichtenstein Herniorafi operasyonu geçiren hastaların izlem sonuçlarının karşılaştırılması

Yıl 2020, Cilt: 45 Sayı: 3, 814 - 820, 30.09.2020
https://doi.org/10.17826/cumj.662917

Öz

Amaç: Bu çalışma, laparoskopik total ekstraperitoneal herniorafi veya Lichtenstein herniorafiyle yöntemlerinden birisiyle inguinal herni operasyonu geçiren hastaların izlem sonuçlarının karşılaştırılması amacıyla yapılmıştır.
Gereç ve Yöntem: Bu karşılaştırmalı tanımlayıcı araştırmaya, kasık fıtığı nedeniyle laparoskopik total ekstraperitoneal herniorafi (n=159) veya Lichtenstein herniorafi (n = 159) yöntemlerinden birisiyle opere olan 318 hasta çalışmaya alındı. Postoperatif komplikasyonlar, istirahat ve efor sonrası ağrı düzeyleri, hastanede kalış ve işe dönüş süresi, nüks oranları, yara iyileşmesi, skar miktarı, ameliyattan memnuniyet ve genel sağlık durumu gibi karşılaştırmalarda kullanılan araştırmanın verileri, “Hasta tanıtıcı özellikler bilgi formu” ve “Herniorafi Değerlendirme Formu” kullanılarak toplandı.
Bulgular: TEP ve LH hastaları için ortalama takip süresi sırasıyla 6.67 ± 2.95 ve 4.23 ± 3.06 yıldı. TEP ameliyatı olan hastaların ameliyat sonrası işe başlama süresi daha kısaydı ve ameliyat sonrası skar gelişimi daha. TEP grubunda LH grubundan seroma gelişimi daha fazla görülürken, parestezinin daha az görüldüğü, kalıcı his kaybının ise hiç görülmediği saptandı.TEP onarımı yapılan hastalar LH onarımı yapılanlardan kendilerini daha sağlıklı hissettikleri saptandı.
Sonuç: TEP fıtık onarım yönteminde, daha fazla seroma ve hematom oluşumuna rağmen, TEP onarımının LH onarımına göre daha az parestezi ve kalıcı sinir hasarı sonuçlarına sahip olduğu bulunmuştur. TEP inguinal herni onarımı iyice öğrenildiğinde nüks gelişmesi açısından LH herniorafi yöntemiyle benzer sonuçlar elde edilebilir.

Destekleyen Kurum

Yok

Teşekkür

Niğde Ömer Halis Demir Üniversitesi Tıp Fakültesi Hastanesi Poliklinik personellerine yardımları için teşekkür ederiz.

Kaynakça

  • 1. Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009 Aug;13(4):343-403. 2. Eklund AS, Montgomery AK, Rasmussen IC, Sandbue RP, Bergkvist LA, Rudberg CR.Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: a randomized, multicenter trial with 5-year follow-up.Ann Surg. 2009 Jan;249(1):33-8. 3. Bittner R, Montgomery MA, Arregui E, Bansal V, Bingener J, Bisgaard T et all. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc. 2015 Feb;29(2):289-321. 4. Miserez M, Peeters E, Aufenacker T, Bouillot JL, Campanelli G, Conze J. Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2014 Apr;18(2):151-63. 5. Tantia O, Jain M, Khanna S, Sen B. Laparoscopic repair of recurrent groin hernia: results of a prospective study. Surg Endosc. 2009 Apr;23(4):734-8. 6. Takata MC, Duh QY. Laparoscopic inguinal hernia repair. Surg Clin North Am. 2008 Feb;88(1):157-78, x. 7. McCormack K, Scott NW, Go PM, Ross S, Grant AM; EU Hernia Trialists Collaboration. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;(1):CD001785. 8. Myers E, Browne KM, Kavanagh DO, Hurley M. Laparoscopic (TEP) versus Lichtenstein inguinal hernia repair: a comparison of quality-of-life outcomes. World J Surg. 2010 Dec;34(12):3059 -64. 9. Wall ML, Cherian T, Lotz JC. Laparoscopic hernia repair--the best option? Acta Chir Belg. 2008 Mar-Apr;108(2):186-91. 10. Çelik Y, Tiryaki C. Tek taraflı inguinal hernilerde genel anestezi altında laparoskopik herni tep onarımı ile açık Lichtenstein herni onarımının karşılaştırılması. Kocaeli Med J. 2019; 8(2):155-59. 11. Vidović D, Kirac I, Glavan E, Filipović-Cugura J, Ledinsky M, Bekavac-Beslin M. Laparoscopic totally extraperitoneal hernia repair versus open Lichtenstein hernia repair: results and complications. J Laparoendosc Adv Surg Tech A. 2007 Oct;17(5):585-90. 12. Aliyazicioglu T, Yalti T, Kabaoglu B. Laparoscopic Total Extraperitoneal (TEP) Inguinal Hernia Repair Using 3-dimensional Mesh Without Mesh Fixation. Surg Laparosc Endosc Percutan Tech. 2017 Aug;27(4):282-284. 13. Köckerling F, Koch A, Adolf D, Keller T, Lorenz R, Fortelny RH et al. Has Shouldice Repair in a Selected Group of Patients with Inguinal Hernia Comparable Results to Lichtenstein, TEP and TAPP Techniques? World J Surg. 2018 Jul;42(7):2001-2010. 14. Golani S, Middleton P.Long-term follow-up of laparoscopic total extraperitoneal (TEP) repair in inguinal hernia without mesh fixation. Hernia. 2017 Feb;21(1):37-43. 15. Zhu X, Cao H, Ma Y, Yuan A, Wu X, Miao Y et al. Totally extraperitoneal laparoscopic hernioplasty versus open extraperitoneal approach for inguinal hernia repair: a meta-analysis of outcomes of our current knowledge. Surgeon. 2014 Apr;12(2):94-105. 16. Eker HH, Langeveld HR, Klitsie PJ, van't Riet M, Stassen LP, Weidema WF et al. Randomized clinical trial of total extraperitoneal inguinal hernioplasty vs Lichtenstein repair: a long-term follow-up study. Arch Surg. 2012 Mar;147(3):256-60. 17. Gupta MK, Muley KK, Bethanbhatla MK, Nanavati JD, Manish K, Sarangi R. Mini Totally Extra-Peritoneal Repair of Inguinal Hernia with All 5 mm Ports: An Innovative "555 Technique". J Laparoendosc Adv Surg Tech A. 2017 Mar;27(3):295-301. 18. Rajapandian S, Bhushan C, Sabnis SC, Jain M, Raj PP, Parathasarthi R et al. Single incision multiport versus conventional laparoscopic inguinal hernia repair: A matched comparison. J Minim Access Surg. 2018 Jan-Mar;14(1):44-51.

Comparison of follow-up results of patients undergoing Laparoscopic Total Extraperitoneal Herniorrhaphy or undergoing Lichtenstein Herniorrhaphy

Yıl 2020, Cilt: 45 Sayı: 3, 814 - 820, 30.09.2020
https://doi.org/10.17826/cumj.662917

Öz

Purpose: The aim of this study is to compare the treatment outcomes of patients that were operated for an inguinal hernia surgery with laparoscopic total extraperitoneal (TEP) hernia repair and Lichtenstein herniorrhaphy (LH).
Materials and Methods: This comparative descriptive study, includes a total of 318 inguinal hernia patients treated with TEP herniorrhaphy and 159 patients treated with Lichtenstein herniorrhaphy. The data of the study, "Patient identification data form" and "Herniorrhaphy Assessment Form" were used to collect data regarding the following items: postoperative complications, resting and post-exercise pain levels, length of hospital stay, time of the return to normal activity and work, recurrence rates, wound healing, the amount of scar, satisfaction with surgery and general health status.
ResultsThe mean follow-up period was 6.67±2.95 and 4.23±3.06 years for TEP and LH patients, respectively Post-operative TEP patients were able to return to work sooner and postoperative scar development was less in patients with TEP. Despite having more seroma formation in the TEP group, paresthesia was less common than in the LH group. Patients in the TEP group were found to feel healthier than those in the LH group.
Conclusion: Despite having more seroma and hematoma formation, TEP group had less paresthesia and permanent nerve damage outcomes compared to the LH group. TEP inguinal hernia repair recurrence rates can be close to those of the LH herniorrhaphy method if the operation is performed by a proficient surgeon.

Kaynakça

  • 1. Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009 Aug;13(4):343-403. 2. Eklund AS, Montgomery AK, Rasmussen IC, Sandbue RP, Bergkvist LA, Rudberg CR.Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: a randomized, multicenter trial with 5-year follow-up.Ann Surg. 2009 Jan;249(1):33-8. 3. Bittner R, Montgomery MA, Arregui E, Bansal V, Bingener J, Bisgaard T et all. Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc. 2015 Feb;29(2):289-321. 4. Miserez M, Peeters E, Aufenacker T, Bouillot JL, Campanelli G, Conze J. Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2014 Apr;18(2):151-63. 5. Tantia O, Jain M, Khanna S, Sen B. Laparoscopic repair of recurrent groin hernia: results of a prospective study. Surg Endosc. 2009 Apr;23(4):734-8. 6. Takata MC, Duh QY. Laparoscopic inguinal hernia repair. Surg Clin North Am. 2008 Feb;88(1):157-78, x. 7. McCormack K, Scott NW, Go PM, Ross S, Grant AM; EU Hernia Trialists Collaboration. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev. 2003;(1):CD001785. 8. Myers E, Browne KM, Kavanagh DO, Hurley M. Laparoscopic (TEP) versus Lichtenstein inguinal hernia repair: a comparison of quality-of-life outcomes. World J Surg. 2010 Dec;34(12):3059 -64. 9. Wall ML, Cherian T, Lotz JC. Laparoscopic hernia repair--the best option? Acta Chir Belg. 2008 Mar-Apr;108(2):186-91. 10. Çelik Y, Tiryaki C. Tek taraflı inguinal hernilerde genel anestezi altında laparoskopik herni tep onarımı ile açık Lichtenstein herni onarımının karşılaştırılması. Kocaeli Med J. 2019; 8(2):155-59. 11. Vidović D, Kirac I, Glavan E, Filipović-Cugura J, Ledinsky M, Bekavac-Beslin M. Laparoscopic totally extraperitoneal hernia repair versus open Lichtenstein hernia repair: results and complications. J Laparoendosc Adv Surg Tech A. 2007 Oct;17(5):585-90. 12. Aliyazicioglu T, Yalti T, Kabaoglu B. Laparoscopic Total Extraperitoneal (TEP) Inguinal Hernia Repair Using 3-dimensional Mesh Without Mesh Fixation. Surg Laparosc Endosc Percutan Tech. 2017 Aug;27(4):282-284. 13. Köckerling F, Koch A, Adolf D, Keller T, Lorenz R, Fortelny RH et al. Has Shouldice Repair in a Selected Group of Patients with Inguinal Hernia Comparable Results to Lichtenstein, TEP and TAPP Techniques? World J Surg. 2018 Jul;42(7):2001-2010. 14. Golani S, Middleton P.Long-term follow-up of laparoscopic total extraperitoneal (TEP) repair in inguinal hernia without mesh fixation. Hernia. 2017 Feb;21(1):37-43. 15. Zhu X, Cao H, Ma Y, Yuan A, Wu X, Miao Y et al. Totally extraperitoneal laparoscopic hernioplasty versus open extraperitoneal approach for inguinal hernia repair: a meta-analysis of outcomes of our current knowledge. Surgeon. 2014 Apr;12(2):94-105. 16. Eker HH, Langeveld HR, Klitsie PJ, van't Riet M, Stassen LP, Weidema WF et al. Randomized clinical trial of total extraperitoneal inguinal hernioplasty vs Lichtenstein repair: a long-term follow-up study. Arch Surg. 2012 Mar;147(3):256-60. 17. Gupta MK, Muley KK, Bethanbhatla MK, Nanavati JD, Manish K, Sarangi R. Mini Totally Extra-Peritoneal Repair of Inguinal Hernia with All 5 mm Ports: An Innovative "555 Technique". J Laparoendosc Adv Surg Tech A. 2017 Mar;27(3):295-301. 18. Rajapandian S, Bhushan C, Sabnis SC, Jain M, Raj PP, Parathasarthi R et al. Single incision multiport versus conventional laparoscopic inguinal hernia repair: A matched comparison. J Minim Access Surg. 2018 Jan-Mar;14(1):44-51.
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Cerrahi
Bölüm Araştırma
Yazarlar

Hacı Bolat 0000-0001-9481-7756

Servet Kocaöz 0000-0002-0085-2380

Yayımlanma Tarihi 30 Eylül 2020
Kabul Tarihi 10 Mayıs 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 45 Sayı: 3

Kaynak Göster

MLA Bolat, Hacı ve Servet Kocaöz. “Laparoskopik Total Ekstraperitoneal Herniorafi Veya Lichtenstein Herniorafi Operasyonu geçiren hastaların Izlem sonuçlarının karşılaştırılması”. Cukurova Medical Journal, c. 45, sy. 3, 2020, ss. 814-20, doi:10.17826/cumj.662917.