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首页> 外文期刊>Surgical Endoscopy >Should peritoneal tears be routinely closed during laparoscopic total extraperitoneal repair of inguinal hernias? A reappraisal.
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Should peritoneal tears be routinely closed during laparoscopic total extraperitoneal repair of inguinal hernias? A reappraisal.

机译：腹腔镜腹股沟疝完全腹膜外修补期间应常规关闭腹膜撕裂吗？重新评估。

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BACKGROUND: Peritoneal tears (PTs) are not uncommon during the course of laparoscopic total extraperitoneal (LTEP) repair of groin hernias. Most endoscopic surgeons advocate routine closure of these tears. Our approach is not to perform routine closure of PTs. The aim of this study was to evaluate the possible effect of our approach on the intra- and postoperative course of patients in whom PTs were left opened. METHODS: Prospective data were collected for LTEP repairs of 298 hernias performed in 166 consecutive patients. RESULTS: There were 134 primary and 34 recurrent hernias. In 23% of patients, unilateral or bilateral PTs were observed during the course of operation. Of these, the prevalence of tears was 21.8% for primary repair and 41% for recurrent repair. In 40 patients with PTs, the procedure was accomplished successfully laparoscopically. The early postoperative course was uncomplicated in all patients. Results of outpatient follow-up with a mean observation time of 16 months (range, 2-30) did not reveal any complications that could be attributed to PTs. CONCLUSIONS: These data demonstrate that PTs do not have to be routinely closed and the majority of cases may be safely managed without peritoneal closure. We have not observed any intra- or postoperative complications that could be attributed to peritoneal tears.
机译：背景：在腹腔镜腹股沟疝的腹膜全腹膜外手术（LTEP）修复过程中，腹膜撕裂（PTs）并不罕见。大多数内窥镜外科医师主张常规封闭这些眼泪。我们的方法不是执行PT的常规关闭。这项研究的目的是评估我们的方法对保留PT的患者的术中和术后过程的可能影响。方法：收集了166例连续患者的298例疝气的LTEP修复的前瞻性数据。结果：原发性疝134例，复发性34例。在23％的患者中，在手术过程中观察到单侧或双侧PT。其中，一次修复的眼泪患病率为21.8％，而反复修复的眼泪患病率为41％。在40例PT患者中，腹腔镜手术成功完成。所有患者术后早期病程并不复杂。平均观察时间为16个月（范围2-30）的门诊随访结果未显示可归因于PT的任何并发症。结论：这些数据表明，PTs不必常规关闭，并且大多数病例无需腹膜封闭即可安全治疗。我们还没有观察到任何可归因于腹膜撕裂的术中或术后并发症。

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