首页> 外文期刊>Surgical laparoscopy, endoscopy and percutaneous techniques >Postoperative pulmonary dysfunction after bilateral inguinal hernia repair: a prospective randomized study comparing the Stoppa procedure with laparoscopic total extraperitoneal repair (TEPP).
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Postoperative pulmonary dysfunction after bilateral inguinal hernia repair: a prospective randomized study comparing the Stoppa procedure with laparoscopic total extraperitoneal repair (TEPP).

机译:双侧腹股沟疝修补术后的肺功能不全:一项前瞻性随机研究,比较了Stoppa手术与腹腔镜全腹膜外修补(TEPP)。

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摘要

The infraumbilical incision required for open repair of bilateral inguinal hernia with a giant prosthesis is associated with postoperative pain and respiratory impairment. The aim of this study was to evaluate the postoperative respiratory dysfunction after bilateral hernia surgery. Thirty-nine patients were randomized into two groups: open repair according to the Stoppa technique and laparoscopic extraperitoneal repair (TEPP). Respiratory function tests were performed before and 24 hours after surgery. The two groups were well matched for age, American Society of Anesthesiologists (ASA) risk score, type of hernia, and preoperative lung function. The postoperative forced vital capacity (FVC), peak expiratory flow (PEF), and forced expiratory volume in 1 second (FEV 1.0) were significantly altered in both groups. The PEF dropped 15% in both groups. The FVC dropped 22% after Stoppa versus 25% after laparoscopy (P = 0.7). The FEV 1.0 dropped 21% after Stoppa versus 9% after laparoscopy (P = 0.12). We conclude that laparoscopic preperitoneal and open bilateral hernia repair are followed by similar ventilatory dysfunction, although a trend toward better postoperative FEV 1.0 was noted after laparoscopy. This might play a role in selected patients with severe pulmonary limitations. Overall, the limited drop in pulmonary function following bilateral hernia repair under general anesthesia may serve to explain the low pulmonary morbidity that follows these procedures.
机译:用巨大的假体进行双侧腹股沟疝的开放修补所需要的脐下切口与术后疼痛和呼吸功能障碍有关。这项研究的目的是评估双侧疝手术后的术后呼吸功能障碍。 39例患者被随机分为两组:根据Stoppa技术进行的开放性修复和腹腔镜腹膜外修复(TEPP)。术前和术后24小时进行呼吸功能测试。两组患者的年龄,美国麻醉医师学会(ASA)风险评分,疝气类型和术前肺功能均很匹配。两组的术后强制肺活量(FVC),峰值呼气流量(PEF)和1秒内强制呼气量(FEV 1.0)均发生了显着变化。两组的PEF均下降15%。 Stoppa后FVC下降22%,而腹腔镜检查后FVC下降25%(P = 0.7)。 Stoppa后FEV 1.0下降21%,而腹腔镜检查后FEV 1.0下降9%(P = 0.12)。我们得出的结论是,尽管腹腔镜检查发现术后FEV 1.0趋于改善,但腹腔镜腹膜前和开放性双侧疝修补术后伴有类似的通气功能障碍。这可能在某些患有严重肺功能受限的患者中起作用。总体而言,在全身麻醉下双侧疝修补术后肺功能的有限下降可能可以解释这些程序导致的低肺部发病率。

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