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Objective:To summarize the experience of laparoscopic transabdominal preperitoneal hernia repair (TAPP) and to discuss its safety and feasibility.Methods:Data of 26 consecutive cases from January 2015 to March 2018 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were analyzed retrospectively. They were all males, aged (68.3±14.1) years, with a range from 57 to 86 years. Body mass index was (23.3±4.1) kg/m 2. Bathel indexwas 91.4±5.6. Intraoperative main procedures were done in accordance to Guideline of Standardized Operation for Laparoscopic Inguinal Hernia Repair. A drainage tube or catheter was not routinely placed intraoperatively. Patients were discharged but for any complaints. Observation data included intraoperative, postoperative and following-up data. The following-up period was more than 12 months by telephone or clinic. The long-term complications and the changes of Barthel index were observed. Paired sample t test was used to compare the changes of Barthel index before and after operation. Results:Of the 26 cases, none was converted to open procedure and no intra- or post-operative serious complications occurred. Occurrence of surgical site seroma was 17 (65.4%) cases. The operating time was (76.5±23.6) min. Intraoperative blood loss was (8.6±4.4) mL. The postoperative hospitalization was (2.3±1.2) d. Bathel index in 1 month postoperative was 96.9±3.2. It was higher statistically than that preoperative ( t=-6.968, P=0.000). Conclusions:TAPP in the treatment of huge inguinoscrotal hernia is safe and feasible. Mastering the anatomical characteristics and the according procedures is an important factor for successful operation.
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<p><b>OBJECTIVE</b>To explore the safety and feasibility of reduced-port laparoscopic-assisted resection for cancer at the sigmoid colon and upper rectum.</p><p><b>METHODS</b>Clinical data of 70 patients with sigmoid colon or upper rectal cancer undergoing laparoscopic-assisted resection in our department from February 2013 to July 2014 were retrospectively reviewed. Patients were divided into reduced-port group (44 cases, 3 or 4 ports) and conventional group (26 cases, 5 ports). The operative time, blood loss, retrieved lymph nodes, postoperative exhaust recovery, dietary recovery, hospital stay and morbidity of complication were compared between two the groups.</p><p><b>RESULTS</b>No significant differences were observed in operative time [(144.0 ± 40.1) min vs. (115.8 ± 30.8) min], blood loss [(72.9 ± 50.2) ml vs. (45.5 ± 52.4) ml], number of retrieved lymph nodes [(10.2 ± 8.4) vs. (12.0 ± 5.6)], time to bowel function return [(3.2 ± 0.7) d vs. (2.8 ± 0.8) d], time to liquid diet [(4.2 ± 1.1) d vs. (3.8 ± 0.9) d], time to semisolid diet [(8.6 ± 2.1) d vs (8.1 ± 1.7) d], and postoperative hospital stay [(13.0 ± 3.4) d vs. (12.8 ± 7.2) d] between two groups (all P>0.05). Complication rate of conventional group and the reduced-port group was 15.4% and 7.2% without significant difference (P=0.233).</p><p><b>CONCLUSIONS</b>For cancer at the sigmoid colon and upper rectum, reduced-port laparoscopic surgery is feasible, safe and radical as the five-port in terms of technical and oncologic issues. These two procedures have the same short-term outcome.</p>