Article information
Introducción. El tratamiento de la hernia inguinal mediante laparoscopia se puede realizar sin violar la cavidad peritoneal mediante una técnica totalmente extraperitoneal. Este procedimiento habitualmente se realiza bajo anestesia general.
Objetivo. Evaluar las técnicas anestésicas (general o regional) en la cirugía laparoscópica extraperitoneal para el tratamiento de la hernia inguinal.
Pacientes. Estudio clínico retrospectivo de 70 pacientes portadores de hernia inguinal no complicada (82 reparaciones) y operados mediante laparoscopia extraperitoneal.
Métodos. Se realizan dos grupos de estudio según la anestesia utilizada: general (n = 36) o regional (n = 34), y se analizan datos clínicos (edad, sexo, localización y tipo de hernia), complicaciones intraoperatorias y postoperatorias, índice de reconversiones, estancia hospitalaria y estudio temporal de la técnica.
Resultados. Ambos grupos eran comparables en cuanto a edad, sexo y enfermedades asociadas. No se han demostrado diferencias estadísticamente significativas en cuanto al tiempo quirúrgico, a las complicaciones intra o postoperatorias o a la necesidad de reconvertir a una técnica abierta. Sólo la estancia hospitalaria media resultó modificada en función de la anestesia, con significación estadística (p < 0,05).
Conclusión. La anestesia general no es imprescindible para realizar la técnica laparoscópica extraperitoneal en el tratamiento de la hernia inguinal. La anestesia regional es igualmente segura y, en nuestro estudio, permite un alta hospitalaria más precoz
Objetivo. Evaluar las técnicas anestésicas (general o regional) en la cirugía laparoscópica extraperitoneal para el tratamiento de la hernia inguinal.
Pacientes. Estudio clínico retrospectivo de 70 pacientes portadores de hernia inguinal no complicada (82 reparaciones) y operados mediante laparoscopia extraperitoneal.
Métodos. Se realizan dos grupos de estudio según la anestesia utilizada: general (n = 36) o regional (n = 34), y se analizan datos clínicos (edad, sexo, localización y tipo de hernia), complicaciones intraoperatorias y postoperatorias, índice de reconversiones, estancia hospitalaria y estudio temporal de la técnica.
Resultados. Ambos grupos eran comparables en cuanto a edad, sexo y enfermedades asociadas. No se han demostrado diferencias estadísticamente significativas en cuanto al tiempo quirúrgico, a las complicaciones intra o postoperatorias o a la necesidad de reconvertir a una técnica abierta. Sólo la estancia hospitalaria media resultó modificada en función de la anestesia, con significación estadística (p < 0,05).
Conclusión. La anestesia general no es imprescindible para realizar la técnica laparoscópica extraperitoneal en el tratamiento de la hernia inguinal. La anestesia regional es igualmente segura y, en nuestro estudio, permite un alta hospitalaria más precoz
Palabras clave:
Hernia inguinal
Anestesia
Laparoscopia extraperitoneal
Introduction. Laparoscopic treatment of inguinal hernias can be performed without invading the peritoneal cavity by means of a totally extraperitoneal approach. This procedure is usually carried out under general anesthesia.
Objective. To evaluate the use of general and regional anesthesia in extraperitoneal laparoscopic surgery for the treatment of inguinal hernia.
Patients. The clinical outcome of 70 patients who underwent extraperitoneal laparoscopic surgery to treat uncomplicated inguinal hernias (82 repairs) was studied retrospectively.
Methods. The patients were divided into two different study groups according to the type of anesthesia utilized: general (n = 36) or regional (n = 34). The groups were compared in terms of clinical data (age, sex, location and type of hernia), intraoperative and postoperative complications, the rate of conversion to open surgery, hospital stay and operative time.
Results. The two groups were comparable with respect to age, sex and associated diseases. There were no statistically significant differences in operative time, intraoperative and postoperative complications or the rate of conversion to open surgery. Only the mean hospital stay was significantly modified by the anesthetic technique (p < 0.05).
Conclusion. General anesthesia is not indispensable in extraperitoneal laparoscopic repair of inguinal hernias. Regional anesthesia is equally safe and, in our experience, was associated with an earlier hospital discharge
Objective. To evaluate the use of general and regional anesthesia in extraperitoneal laparoscopic surgery for the treatment of inguinal hernia.
Patients. The clinical outcome of 70 patients who underwent extraperitoneal laparoscopic surgery to treat uncomplicated inguinal hernias (82 repairs) was studied retrospectively.
Methods. The patients were divided into two different study groups according to the type of anesthesia utilized: general (n = 36) or regional (n = 34). The groups were compared in terms of clinical data (age, sex, location and type of hernia), intraoperative and postoperative complications, the rate of conversion to open surgery, hospital stay and operative time.
Results. The two groups were comparable with respect to age, sex and associated diseases. There were no statistically significant differences in operative time, intraoperative and postoperative complications or the rate of conversion to open surgery. Only the mean hospital stay was significantly modified by the anesthetic technique (p < 0.05).
Conclusion. General anesthesia is not indispensable in extraperitoneal laparoscopic repair of inguinal hernias. Regional anesthesia is equally safe and, in our experience, was associated with an earlier hospital discharge
Keywords:
Inguinal hernia
Anesthesia
Extraperitoneal laparoscopy
