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Amaç: Bu çalışmada laparoskopik herni tamirinde kullanılan iki yöntemi karşılaştırmak ve hangi tekniğin hangi hasta gruplarında üstün olabileceğini araştırmak amaçlanmıştır. Gereç ve Yöntemler: Ocak 2016—Ocak 2018 döneminde hastanemizde inguinal herni tanısı alıp laparoskopik transabdominal preperitoneal (TAPP) ve total ekstraperitoneal (TEP) yöntemle opere edilen hastaların kayıtları retrospektif olarak incelendi. Çalışmaya 18 yaş üstü, elektif ameliyat edilen ve primer inguinal hernisi olan hastalar dahil edildi. Hastaların yaş, cinsiyet, ameliyat süresi, yatış süresi, takip süresi, hematom ve seroma oluşumu, testis enflamasyonu, kronik kasık ağrısı, yeniden opere edilme ve nüks ve komplikasyon gelişimi verileri incelendi. Bulgular: TEP yöntemle opere edilmiş 99 (96 erkek, 3 kadın), TAPP yöntemle opere edilmiş 65 (59 erkek, 6 kadın) hasta çalışmaya dahil edildi. Ortalama TEP ve TAPP hasta yaşı sırasıyla 50,3±12 ve 52,7±9,4 yıl olarak tespit edildi. İki grup arasında seroma oluşumu ve nüks gelişimi bakımından anlamlı fark görülmedi (p>0,005). Ortalama ameliyat süresi TEP hastalarda (70,4±25,9 dk.) TAPP hastalara (66,0±26,5 dk.) kıyasla daha uzun olmakla birlikte fark istatistiksel olarak anlamlı değildi. Ortalama yatış ve işe dönüş süreleri benzerdi. Tartışma ve Sonuç: Laparoskopik herni tamirinde TEP ve TAPP yöntem karşılaştırılmış, bu iki yöntemle kaydedilen ortalama ameliyat ve işe dönüş sürelerinin, nüks ve komplikasyon oranlarının benzer olduğu görülmüştür. Batın içi yapışıklıkları olan hastalarda TEP, geniş eksplorasyon gereken durumlarda TAPP yöntem daha uygun görünmektedir.
Purpose: This study aims to compare the two methods used in the repair of laparoscopic herni and to explore which technique can be superior in which patients groups. In the period January-January-January 2018, the records of patients diagnosed with inguinal herni in our hospital and operated with laparoscopic transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) methods were retrospective examined. The study included patients over the age of 18 who were selectively operated and with primary inguinal hernia. The patient’s age, gender, duration of surgery, duration of sleep, duration of follow-up, hematoma and seroma formation, testicular inflammation, chronic scalp pain, reoperation and nickel and complication development data were studied. The findings: 99 patients operated with TEP method (96 men, 3 women), 65 (59 men, 6 women) operated with TAPP method were included in the study. The average TEP and TAPP patient age was identified as 50,3±12 and 52,7±9,4 years respectively. There was no significant difference between the two groups in terms of the formation of seroma and the development of nuts (p>0,005). The average duration of the surgery in TEP patients (70.4 ± 25.9 minutes) TAPP for patients (66,0 ± 26,5 min) Although the difference was longer compared, it was not statistically meaningful. The average time of residence and return to work was similar. Debate and Result: The TEP and TAPP methods compared in the labaroscopic hernial repair, the average surgery and return time recorded by these two methods have been shown to be similar to the nick and complication rates. In patients with intramuscular adhesions, the TEP method appears to be more suitable in cases that require extensive exploration.
Aim: In this study, we aimed to compare two techniques used in laparoscopic hernia repair and investigate which technique might be superior in which patient groups. Materials and Methods: We retrospectively reviewed the medical records of patients who were diagnosed with inguinal hernia in our hospital and surgically treated with the laparoscopic transabdominal preperitoneal (TAPP) and total extraperitoneal (TEP) techniques between January 2016 and January 2018. The study included patients with primary inguinal hernia who were aged >18 years and operated on electively. We reviewed the patient data concerning age, sex, operation time, hospital stay, follow-up time, hematoma and seroma formation, testis inflammation, chronic groin pain, re-operation status, and recurrence and complication development. Results: The study included 99 (96 males, 3 females) patients treated with TEP surgery and 65 (59 males, 6 females) patients who underwent TAPP surgery. The mean TEP and TAPP patient age were 50.3±12 and 52.7±9.4 years, respectively. There was no significant difference between the two groups in terms of seroma formation or hernia recurrence (p>0.005). Although the mean operation time was longer for the TEP group (70.4±25.9 min) than for the TAPP group (66.0±26.5 min), the difference was not statistically significant. The mean hospital stay and return-to-work time were similar. Discussion and Conclusion: We compared the TEP and TAPP techniques in laparoscopic hernia repair and found that the two techniques resulted in similar mean operation and return-to-work times and recurrence and complication rates. The TEP technique is more appropriate for patients with intra-abdominal adhesions while the TAPP technique appears to be more convenient in cases requiring extensive exploration.
Alan : Sağlık Bilimleri
Dergi Türü : Uluslararası
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