Transabdominal preperitoneal approach法における臍部トロッカー細径化の有用性

Effect of size-reduced umbilical trocar in transabdominal preperitoneal hernia repair

◆要旨：［目的］Transabdominal preperitoneal approach（TAPP）による鼠径ヘルニア修復術における臍部トロッカー細径化の有用性の評価．［方法］2011年11月から2017年8月までに臍部12mmカメラトロッカー使用の86例（12mm TAPP）と5mmオプティカルトロッカーに変更した61例（5mm TAPP）の手術因子，術後鎮痛薬使用回数を比較した．［成績］5mm TAPPは12mm TAPPと比べ出血量，合併症頻度および再発率は同等で術当日の鎮痛薬使用回数はマッチドペア解析後も有意に少なかった．［結論］臍部トロッカーの細径化により安全性，根治性は損なわず低侵襲性が高まった．

【Aim】 To clarify the effect of size-reduced umbilical trocar in transabdominal preperitoneal hernia repair （TAPP）. ［Methods］ The study included 86 patients who underwent TAPP with 12mm umbilical camera-trocar （12mmTAPP）, and 61 patients who underwent TAPP with 5mm optical trocar （5mmTAPP） between November 2011 and August 2017. Operative parameters and frequency for analgesics were compared between the 2 groups. ［Results］ There was no difference between the 2 groups regarding the amount of bleeding, frequencies of post-operative complications and rate of recurrence whereas the frequency for analgesics on the day of operation was significantly fewer in the 5mmTAPP group. ［Conclusion］ Size-reduced umbilical trocar may be less-invasive and there seems to be no increase in complications or recurrence rate.