鼠径ヘルニア日帰り手術におけるリヒテンシュタイン法とtotally extraperitoneal repair（TEP）法の手術短期成績に関する比較検討

Comparison of short term outcomes between Lichtenstein method and totally extraperitoneal repair (TEP) in day surgery for inguinal hernia

◆要旨：鼠径ヘルニア日帰り手術におけるリヒテンシュタイン（LICH）法とtotally extraperitoneal repair（TEP）法の短期手術成績を後ろ向きに検討した．2017年2月から2019年3月の間に当クリニックで待機的に行った成人片側初発鼠径ヘルニア症例でLICH法248例とTEP法120例を検討したところTEP法では手術時間と術後在院時間が有意に延長し，経口鎮痛薬使用個数，追加用の鎮痛坐薬使用割合，手術翌日の疼痛スコア，社会復帰日数に差は認めかなった．術後合併症に関しては皮下出血・血腫，漿液腫に差はないが神経障害に関しては有意に少なかった．日帰り手術においては術後鎮痛を十分にしておけばLICH法とTEP法では術後疼痛，社会復帰において差は認められなかった．

　［Introduction］ We retrospectively compared the short term outcomes of the Lichtenstein（LICH） method and the totally extraperitoneal repair （TEP） method in day surgery for unilateral inguinal hernia. ［Methods］ The data of 248 cases of Lichtenstein and 120 cases of TEP, performed from February 2017 to March 2019 were analyzed. ［Results］ The mean operation time and the postoperative stay in TEP group were significantly longer than Lichtenstein group. There were no differences in postoperative analgesics, pain scores in Day1 and return to work. In TEP group abnormal sensation was significantly less and no significant differences were observed in hemorrhage and seroma. ［Conclusion］ Between the two groups there are no significant differences in postoperative pain and recovery of daily life.