Objective To compare the incidence of inguinal hernia in patients undergoing laparoscopic radical prostatectomy via different approach,and investigate the safety and efficiency of laparoscopic tension-free hernia repair for inguinal hernia after radical prostatectomy.
Methods Clinical data was collected retrospectively for 312 patients received laparoscopic radical prostatectomy from November,2007 to July,2014,including 223 intraperitoneal and 89 extraperitoneal (preperitoneal) radical prostatectomy.All patients were followed up from 3 months to 2 years.If inguinal hernia occurred in the follow-up period,the patients were invited to return to the hospital for laparoscopic tension-free hernia repair.The operative duration,drainage time,hospitalization days and all perioperative complications were documented.All patients were followed up for one year,in order to observe the recurrence of inguinal hernia.
Results The inguinal hernia of intraperitoneal and preperitoneal prostatectomy were 10 cases and 3 case,respectively.For intraperitoneal approach,there were 8 cases of inguinal hernia in bilateral lymphadenectomy and 2 cases in patients without bilateral lymphadenectomy.All patients of inguinal hernia underwent laparoscopic tension-free hernia repair.The mean operative time was 28 min (15 to 50 min).There was no intraoperative blood transfusion,conversion to open surgery cases or postoperative complications.Peritoneal drainage tube lasted 1-3 d,and the average hospital stay was 5 d (3 to 7 d).The patients were followed up 1-12 months with an average of 10 months,and no recurrent inguinal hernia was found.
Conclusion Inguinal hernia is one of the major complications of laparoscopic radical prostatectomy.Laparoscopic approach and bilateral inguinal lymph node dissection are not influence factors of hernia;laparoscopic hernia tension repair is a safe and effective minimally invasive treatment for inguinal hernia surgery.Long-term efficacy remains to be seen for longer follow-up.