İnguinal Hernilerde Laparoskopik Total Ekstraperitoneal Onarım Sonuçlarının Cerrahi Deneyim ile Korelasyonu

GİRİŞ ve AMAÇ: Günümüzde laparoskopik herni onarımları popüler hale gelmiştir. Bu çalışmanın amacı, laparoskopik total ektraperitoneal (TEP) inguinal herni onarımı uygulanan hastaların, intraoperatif ve postoperatif sonuçlarının irdelenmesi ve öğrenme eğrisinin öneminin belirtilmesidir. YÖNTEM ve GEREÇLER: 2012-2019 tarihleri arasında hastanemizde laparoskopik TEP inguinal herni onarımı yapılan hastalar retrospektif olarak incelendi. Yaş, cinsiyet, intraoperatif ve postoperatif görülen komplikasyonlar, ameliyat süresi, hastanede yatış süresi, iş/günlük aktiviteye dönüş süresi, ağrı ve nüks parametreleri değerlendirildi. BULGULAR: Çalışma 96’sı, tek taraflı, 44’ü çift taraflı olmak üzere 140 fıtık hastasına uygulanan 184 prosedür onarımı sonuçları üzerinde yapılmıştır. Ortalama yaş 50.55±15.01 yıldır. 126’sı erkek, 14’ü kadındır. Hastaların 98’i 65 yaş altında iken, 42’si 65 yaş üzerindedir. Aktivite/ işe dönüş sürelerinin ortalaması 4.88±1.57 gün, ameliyat süresinin ortalaması 59.53±21.21dakikadır. Hastanede kalış süresinin ortalaması 1.02±0.14 gündür. Olguların %9,3 ünde intraoperatif komplikasyon, %5,7’sinde postop ağrı, %5’inde seroma görülmüştür. 3.ay kontrolünde 6 hastada ılımlı ağrı görülmüştür. 1.yıl kontrolünde 5 hastada nüks görülmüştür. TARTIŞMA ve SONUÇ: Laparoskopik TEP inguinal herni onarımı literatürdeki açık ve laporoskopik onarımlar ile kıyaslandığında komplikasyon oranlarının benzer, hastanede yatış ve günlük aktivite/ işe dönüş sürelerin kısa olması ve daha az postoperatif ağrı izlenmesi yönlerinden güvenli bir cerrahi metodudur.

Correlation of Laparoscopic Total Extraperitoneal Repair Results With Surgical Experience in İnguinal Hernias

INTRODUCTION: Laparascopic hernia repairs have become popular nowadays. The aim of this study is to evaluate the intraoperative and postoperative outcomes of patients who underwent laparoscopic total extraperitoneal (TEP) inguinal hernia repair and to emphasize the importance of learning curve. METHODS: Patients who underwent laparoscopic TEP inguinal hernia repair in our hospital between 2012-2019 were retrospectively analyzed. Age, gender, intraoperative and postoperative complications, duration of operation, postop hospital stay,time to return to work/ daily activity, pain and recurrence parameters were evaluated. RESULTS: The study has been conducted on the results of 184 procedure repairs applied to 140 hernia patients, 96 of them unilateral and 44 bilateral. The average age is 50.55±15.01years, 126 patients are men and 14 patients are women. While 98 of the patients are under 65 years old, 42 of them are over 65 years old. The average duration of activity/return to work is 4.88±1.57 days and the average duration of operation is 59.53±21.21 minutes. Duration of staying in hospital is 1.02±0.14 days. %9,3 Intraoperative complication, %5,7 postop pain, %5 seroma were observed among cases. At the 3rd month checkup 6 patients experienced moderate pain, recurrence was observed in 5 patients at the 1st year checkup. DISCUSSION AND CONCLUSION: Laparascopic TEP inguinal hernia repair is a safe surgical procedure in terms of less postoperative pain, shorter hospital stay,shorter time return to daily activity, similar complication rates compared to laparoscopic and open repairs in literature.

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