若年成人鼠径ヘルニアに対する laparoscopic percutaneous extraperitoneal closure（LPEC）法の適応条件の検討

Laparoscopic percutaneous extraperitoneal closure for young adults

◆要旨：【目的】若年成人外鼠径ヘルニアに対するlaparoscopic percutaneous extraperitoneal closure（LPEC）法の適応条件を検討した．【方法】若年成人に対してLPEC法を施行した症例と，transabdominal preperitoneal repair（TAPP）法を施行した症例との成績比較を行った．【成績】LPEC法はTAPP法に比べ，手術時間が短く短期入院で施行可能であった．術後創感染は認めず，術後疼痛も軽微であった．社会復帰までの日数も短く，再発症例はなかった．【結論】LPEC法は症例を適切に選択すれば若年成人外鼠径ヘルニアも根治できる術式である．

　［Purpose］To investigate conditions indicated for laparoscopic percutaneous extraperitoneal closure（LPEC） in adults with external inguinal hernia. ［Methods］LPEC was performed in 32 young adult patients suffering with external inguinal hernia. A comparison was made with transabdominal preperitoneal repair（TAPP） in 25 young adult patients suffering with external inguinal hernia. ［Results］Median operative time was shorter in LPEC. Hospital stays were short and surgical site infection（SSI） occurred in none of LPEC. No recurrence or onset on the opposite side was observed in LPEC. ［Conclusion］LPEC can be considered as a superior treatment option for young adult external inguinal hernia due to its needless mesh, shorter operative time, hospital stay, decreased postoperative pain, no SSI, earlier return to work or school, no recurrence, and lower medical costs.