アンケート調査による鼠径ヘルニア修復術後晩期疼痛の検討—内視鏡下アプローチと鼠径部切開法の予後比較

Questionnaire survey to evaluate long-term outcomes after inguinal hernia repair : Comparison of prognosis of endoscopic vs. open inguinal hernia repair

◆要旨：【緒言】内視鏡下鼠径ヘルニア修復術は術後疼痛が軽度で回復が早いとされるが，長期予後については報告が少ない．今回筆者らは，アンケート調査による鼠径部切開法との予後の比較を行った．【方法】鼠径ヘルニア修復術を行った115症例にアンケート調査を行い，回答が得られた50例を対象として，短期・長期予後を比較検討した．【結果】内視鏡手術の52％，鼠径部切開法の64％で術後疼痛なしと回答を得たが，内視鏡手術の1例では現在も疼痛が続いていた．つっぱり感や異物感に大きな差は認めなかった．【考察】内視鏡下修復術の利点とされる疼痛の軽減は長期予後においては明らかでなく，鼠経ヘルニア修復術におけるアプローチ選択は慎重に検討する必要がある．

　【Introduction】 Endoscopic inguinal hernia repair is associated with mild postoperative pain and rapid recovery ; however, few reports have described its long-term prognosis. We compared outcomes between endoscopic and open inguinal repair using a questionnaire survey. 【Method】 A questionnaire survey was performed on 115 patients who underwent inguinal hernia repair between June 2014 and March 2016. Short- and long-term outcomes were evaluated in 50 patients who responded to the survey. 【Results】 No postoperative pain was reported by 52％ and 64％ of patients who underwent endoscopic and open surgery, respectively. However, postoperative pain persisted in one patient who underwent laparoscopy. 【Discussion】 In this study, endoscopic surgery was significantly associated with postoperative pain. Pain reduction is considered an advantage of endoscopic surgery; however, long-term postoperative pain outcomes associated with this approach remain unclear.