Background

Indirect inguinal hernia with a dilated internal ring but an intact posterior inguinal wall is classified as Nyhus type II. Females have a higher incidence of indirect hernia than direct hernia. The purpose of this study was to evaluate the efficacy of laparoscopic iliopubic tract repair (IPTR) compared with laparoscopic transabdominal preperitoneal (TAPP) hernioplasty in treating women with Nyhus type II hernia.

Methods

This retrospective study included 318 women aged ≥ 20 years who were treated for Nyhus type II hernia from January 2013 to December 2018. The patients were categorized into two groups in accordance with the operative technique: the TAPP group (33 patients) and the IPTR group (285 patients). In the IPTR group, intraabdominal suturing of the iliopubic tract and transversalis fascia arch was performed without mesh implantation.

Results

The mean operation time was shorter in the IPTR group (17.2 ± 3.9 min) than the TAPP group (20.5 ± 8.1 min, p = 0.028). The postoperative complication rate was higher in the TAPP group than the IPTR group [6.1% (2/33) vs. 0.4% (1/285), respectively; p = 0.001]. Inguinodynia occurred in one patient in the TAPP group and no patients in the IPTR group. The hospital stay did not significantly differ between the two groups. The numeral rating scale pain scores at 1 day and 1 week postoperatively did not significantly differ between the two groups. There was no recurrence in either group.

Conclusions

Laparoscopic IPTR was safe and feasible for treating Nyhus type II hernia in women.

中文翻译：

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腹腔镜经腹腹膜前疝修补术与腹腔镜髂耻道修补术治疗女性 Nyhus II 型疝的比较

背景

内环扩张但腹股沟后壁完整的间接腹股沟疝被归类为 Nyhus II 型。女性患间接疝的几率高于直接疝。本研究的目的是评估腹腔镜髂耻束修复术 (IPTR) 与腹腔镜经腹腹膜前疝修补术 (TAPP) 治疗 Nyhus II 型疝的疗效。

方法

本回顾性研究纳入 2013 年 1 月至 2018 年 12 月接受 Nyhus II 型疝治疗的 318 名 20 岁以上女性。根据手术技术将患者分为两组：TAPP 组（33 例）和 IPTR 组（285 名患者）。在IPTR组中，髂耻束和横筋膜弓的腹内缝合不进行网状植入。

结果

IPTR 组的平均手术时间（17.2 ± 3.9 分钟）短于 TAPP 组（20.5 ± 8.1 分钟，p  = 0.028）。TAPP 组的术后并发症发生率高于 IPTR 组 [分别为 6.1% (2/33) 和 0.4% (1/285)；p  = 0.001]。TAPP 组有 1 例患者出现腹股沟痛，IPTR 组没有患者出现腹股沟痛。两组的住院时间没有显着差异。两组在术后 1 天和 1 周的数字评定量表疼痛评分无显着差异。两组均未复发。

结论

腹腔镜 IPTR 治疗女性 Nyhus II 型疝是安全可行的。