腹腔鏡下鼠径ヘルニア修復術による両側修復症例の手術成績

Surgical outcome of bilateral transabdominal preperitoneal（TAPP）repair for inguinal hernias

◆要旨：［目的］両側鼠径ヘルニアに対するtransabdominal preperitoneal hernia repair（以下，TAPP）法の短期手術成績を検討する．［方法］TAPPを施行した（複雑症例を除外）鼠径ヘルニア597例677病変を対象とした．片側修復517例をUnilateral群（以下，U群），両側80例160病変をBilateral群（以下，B群）に分類し，手術成績，術後アンケート調査の結果を比較した．［結果］手術時間，術中出血量はB群で有意に増加したが，術後在院日数や翌日退院症例の割合は両群に有意差を認めなかった．再発率（U群0％，B群1.3％），合併症発症率（U群1.9％，B群3.8％），鎮痛剤使用回数や患者アンケート結果は両群間で有意な差を認めなかった．［結論］TAPPは両側修復が必要な症例に対して短期的手術成績は良好であると考えられた．

［Aim］Short-term surgical outcome of transabdominal preperitoneal （TAPP） repair for bilateral inguinal hernias was assessed. ［Methods］The study included 597 inguinal hernia patients with 677 lesions, excluding the complicated cases, who were treated by TAPP repair. The patients were divided into 2 groups : unilateral repair group （U group, 517 patients with 517 lesions） and bilateral group （B group, 80 patients with 160 lesions）. The two groups were compared in terms of surgical outcome and the results of postoperative questionnaire survey. ［Results］Operation time and intraoperative blood loss were significantly greater in group B, but there were no significant differences between the two groups in postoperative length of stay or proportion of patients who could be discharged the following day. No significant differences between the two groups were observed in recurrence rates （U group, 0％; B group, 1.3％）, complication rates （U group, 1.9％; B group, 3.8％）, number of postoperative analgesic doses administered, or results of postoperative patient questionnaire. ［Conclusion］The short-term postoperative outcome of TAPP appeared to be favorable in patients who required bilateral repair.