Can laparoscopic total extraperitoneal repair of inguinal hernia be preferred to conventional method? A randomized clinical trial

Öz

Objective: This is a prospective study of laparoscopic to­tally extraperitoneal (TEP) inguinal hernia repair to com­pare with the conventional method of Lichtenstein. Methods: A total of 50 patient (25 conventional, 25 lapa­roscopic) with inguinal hernia were included. We were examined prospectively age, gender, body mass index (BMI), inguinal hernia type (Nyhus classification), Ameri­can Society of Anesthesiologists risk score (ASA), the first skin incision until closure operation time, intraopera­tive and postoperative complications, postoperative pain score, analgesic requirement, hospital stay, return to nor­mal physical activity in terms of duration and recurrence on preoperative patient. Visual analog pain score (VAS) were used for scoring pain for all patients. Results: 46 patients (92%) were male and mean age was 50.9 years (range 17-78). The mean BMI was 25,8 kg/m2 (range 19.1-31,6) and there was no significant difference in demographic characteristics between groups (p>0,05). In both groups, mainly Nyhus Type 2 was followed and there was no significant difference in ASA scores and hernia type between the groups (p>0.05). Laparoscopic group was more advantageous in analgesic use, VAS score, and return to work time, but had longer operation time (p0.05). Conclusions: Although laparoscopic TEP hernia repair had longer operation time; it provides less pain, less an­algesic use with similar morbidity rate and provides early discharge. J Clin Exp Invest 2013; 4 (1): 80-83

Anahtar Kelimeler

• Pain, inguinal hernia, total extraperitoneal hernia repair, lichtenstein hernia repair

Laparoskopik total ekstraperitoneal kasık fıtığı tamiri konvansiyonel yönteme tercih edilebilir mi? Randomize klinik çalışma

Öz

Amaç: Bu çalışmada prospektif olarak laparoskopik total ekstraperitoneal (TEP) kasık fıtığı onarımı ile konvansi­yonel Lichtenstein yöntemi karşılaştırmak amaçlanmıştır. Yöntemler: Kasık fıtıklı 50 olgu (25 konvansiyonel, 25 laparoskopik) çalışmaya alındı. Prospektif olarak ame­liyat öncesi olgulara ait yaş, cinsiyet, vücut kitle indek­si (BMI), kasık fıtığı türü (Nyhus sınıflaması), Amerikan Anesteziyoloji Derneği risk skorlaması (ASA), ilk cilt in­sizyonundan kapatılmaya kadar geçen ameliyat süreleri, peroperatif ve postoperatif komplikasyonlar, postoperatif dönemde ağrı skoru, analjezik ihtiyacı, hastanede kalış süresi, normal fizik aktiviteye dönüş süreleri ve nüks açı­sından incelenmiştir. Hastaların tümünün ağrı skorlaması için vizüel analog skala (VAS) kullanılmıştır. Bulgular: Olguların 46(%92)\'si erkek olup ortalama yaş 50,9 (17-78) idi. Sırası ile ortalama BMI değerleri 25,7 ve 25,8 olan gruplar arası demografik özellikler bakımın­dan fark veya istatiksel anlamlılık yoktu (p>0,05). Her iki grupta da ağırlıklı olarak Nyhus Tip 2 izlenmiş olup; fıtık türü ve ASA skorları arasında istatistiksel olarak anlamlı ilişki gözlenmedi (p>0,05). Laparoskopik teknik kullanı­lan grup, konvansiyel gruba göre operasyon süresi daha uzun olmakla birlikte; analjezik kullanımı, VAS skoru, ta­burculuk süresi ve işe dönüş zamanı bakımından daha avantajlı görüldü (p0,05). Sonuç: Laparoskopik TEP fıtık tamiri uzun ameliyat sü­relerine karşın olgunun daha az ağrı duymasını, daha az analjezik kullanımını, benzer morbidite oranı ile erken ta­burculuğunu sağlamaktadır.

Anahtar Kelimeler

• Ağrı, kasık fıtığı, total ekstraperitone­al kasık fıtığı, lichtenstein fıtık tamiri

Kaynakça

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