機械手臂輔助攝護腺根除術後發生腹股溝疝氣之危險因子

林巧文¹、黃逸修^1,2、江長和¹、陳昱光¹、黃子豪^1,2、張延驊^1,2、盧星華^1,2、鍾孝仁^1,2、
林子平^1,2、林志杰^1,2、黃奕燊^1,2、陳威任^1,2、黃志賢^1,2

¹臺北榮民總醫院泌尿部

²國立陽明交通大學醫學院泌尿學科及書田泌尿科學研究中心

Risk Factors of Inguinal Hernia Following Robotic-assisted Laparoscopic Radical Prostatectomy

Chyau-Wen Lin¹, Eric Yi-Hsiu Huang^1,2, Chang-Ho Chiang ¹, Yu-Kuang Chen¹, Tzu-Hao Huang^1,2,
Yen-Hwa Chang^1,2, Shing-Hwa Lu^1,2, Hsiao-Jen Chung^1,2, Tzu-Ping Lin^1,2, Chih-Chieh Lin ^1,2,
I-Shen Huang^1,2, Wei-Jen Chen^1,2, William J. Huang^1,2

¹Department of Urology, Taipei Veterans General Hospital

²Department of Urology, School of Medicine and Shu-Tien Urological Science Research Center,
National Yang Ming Chiao Tung University, Taipei, Taiwan

Purpose

We aim to investigate the risk factors associated with inguinal hernia occurrence in patients underwent robotic assisted laparoscopic radical prostatectomy (RaRP).

Material and Methods

This is a single center retrospective study. Patients who developed inguinal hernia after RaRP and received hernioplasty (RaRP group) were enrolled from 2014 to 2019. Peri-operative variables were collected. Mann-Whitney U test was used in continual variables, and Chi square test was used in categorical and ordinal variables. Logistic regression was used in multivariate analysis.

Result

In total, 630 patients who received RaRP were enrolled. Fifty-seven patients developed post-operative inguinal hernia with an incidence rate of 9.0% at a median follow-up period of 49 months. The median time interval between RaRP and the occurrence of inguinal hernia was 9 months (IQR 6-16) and 80% of the patients developed inguinal hernia within 12 months after RaRP. Univariate analysis showed that elder age, lower BMI, longer drainage indwelling time, longer operation time, bladder neck reconstruction, and performance of urethral suspension stitches were associated with post-operative inguinal hernia. Multivariate analysis showed older age (p=0.007) and lower BMI (p<0.001) are the risk factors for post-operative hernia. After adjusting for operator, there is no significant difference between hernia occurrence and presence of bladder neck reconstruction or urethral suspension.

Conclusion