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KMID : 1033020190090020031
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Journal of Hemiology: Diagnosis and Treatment of Hernias
2019 Volume.9 No. 2 p.31 ~ p.34
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The Feasibility of Laparoscopic Transabdominal Preperitoneal (TAPP) Inguinal Herniorrhaphy after Previous Open Abdominal Surgery
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Byun Geon-Young
Kang Hyok-Jo
Kim Myoung-Jin
Lee Seung-Geun
Koo Bum-Hwan
Lee Sung-Ryul
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Abstract
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Purpose: This study aimed to evaluate the feasibility of laparoscopic transabdominal preperitoneal (TAPP) inguinal herniorrhaphy in patients with a history of previous open abdominal surgery (PAS).
Methods: A retrospective analysis of 1,276 patients undergoing laparoscopic TAPP herniorrhaphy for inguinal hernia at the Damsoyu Hospital, Seoul, Korea, from January 2015 to December 2017 was performed to compare patients with and without PAS.
Results: In total, 59 patients who underwent recurrent inguinal hernia repair and had previous laparoscopic surgery were excluded from the study. Of the remaining 1,217 patients, 136 (11.2%) had a history of PAS, with appendectomy accounting for the most common surgical procedure. Operation times were slightly longer in the PAS group than the non-PAS group (29.5±22.2 min vs. 27.8±15.9 min, P=0.379). Conversion to totally extraperitoneal (TEP) or open herniorrhaphy was necessitated in only 4 cases, all of whom had a history of PAS (P<0.001). There were no statistically significant differences in postoperative complications between the two groups (2.25% vs. 1.56%, P=0.468). The mean hospital stay was 14.3±10.0 hours for the PAS group and 12.7±12.1 hours for the non-PAS group (P=0.050). The PAS and non-PAS groups had, respectively, 1 (0.75%) and 4 (0.36%) cases of recurrence, without revealing any remarkable difference (P=0.836).
Conclusion: Laparoscopic TAPP herniorrhaphy produced similar perioperative outcomes and recurrence rates in both PAS and non-PAS groups. Therefore, the laparoscopic approach is feasible and should be considered in patients with inguinal hernia and a history of PAS.
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KEYWORD
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TAPP, Inguinal herni, , Open abdominal surgical history
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