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首页> 外文期刊>Surgical Endoscopy >Incisional hernia repair Retrospective comparison of laparoscopic and open techniques.
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Incisional hernia repair Retrospective comparison of laparoscopic and open techniques.

机译：切口疝修补术回顾性比较腹腔镜和开放技术。

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Purpose: A retrospective clinical trial was conducted to compare laparoscopic incisional hernia repair (LIHR) and open traditional repair (OR). Demographics, perioperative data, results, and follow-up data were examined to determine whether there was any difference in outcome, recurrences, and costs. Methods: From January 2000 to June 2002, 42 consecutive, unselected patients who successfully underwent LIHR were matched with 49 consecutive, unselected patients who received OR during the same period. The operating room database, clinical files, and outpatient sheets were examined. Patient demographics, results, follow-up data, and costs were compared between the two groups. Results: Demographic characteristics, obesity, ASA status, type of hernia, concomitant surgery, urgencies, and incidences of previous repair were well matched between the two groups. Hernia defect was significantly larger in the OR group (122 cm(2)) than in the LIHR group (83 cm(2); p = 0.0006). The operative times and the overall complications rates were similar, but wound infections were more common in the OR group (12% vs 0%; p = 0.04). The analgesic requirement was smaller (mean ketorolac injections, 2 vs 5; p < 0.0001; additional opiates, 0% vs 24%; p = 0.0006) and the hospital stay was shorter (5 vs 8 days; p < 0.0001) in the LIHR group. No recurrences were noted in the LIHR group, but there were three recurrences (6%) in the OR group ( p = 0.30, not statistically significant). The cost of the prosthesis was higher for laparoscopic procedure, although the reduction in the hospital stay largely balanced the overall cost ( p = 0.017). Conclusions: In this study, LIHR appeared to be as safe as OR. Despite the fact that LIHR raised the prosthesis-related costs, the findings showed that LIHR has clinical (less wound complications, shorter hospital stay, reduced pain) and financial advantages over OR.
机译：目的：进行一项回顾性临床试验，以比较腹腔镜切开疝修补术（LIHR）和开放式传统修补术（OR）。检查人口统计学，围手术期数据，结果和随访数据，以确定结果，复发和费用是否存在任何差异。方法：自2000年1月至2002年6月，将42例成功接受LIHR的连续未选择患者与49例同期接受OR的连续未选择患者配对。检查了手术室数据库，临床文件和门诊病人床单。比较了两组患者的人口统计学，结果，随访数据和费用。结果：两组的人口统计学特征，肥胖，ASA状态，疝气类型，伴随手术，急迫性和先前修复的发生率非常匹配。 OR组（122 cm（2））的疝气缺损明显大于LIHR组（83 cm（2）; p = 0.0006）。手术时间和总体并发症发生率相似，但在OR组中伤口感染更为常见（12％vs 0％; p = 0.04）。 LIHR的镇痛要求较小（平均酮咯酸注射液，2 vs 5; p <0.0001;其他鸦片制剂，0％vs 24％; p = 0.0006），住院时间较短（5 vs 8天; p <0.0001）组。 LIHR组未发现复发，但OR组有3例复发（6％）（p = 0.30，无统计学意义）。腹腔镜手术的假体成本更高，尽管住院时间的减少在很大程度上抵消了总体成本（p = 0.017）。结论：在这项研究中，LIHR似乎和OR一样安全。尽管LIHR增加了与假体相关的费用，但研究结果表明LIHR具有比OR更好的临床（伤口并发症少，住院时间短，疼痛减轻）和经济优势。

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