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Background: The aim of this study was to compare operating time and short-term
complications of laparoscopic transabdominal preperitoneal hernia repair during
reperitonealization in Trendelenburg versus reverse-Trendelenburg positions.
Methods : Thirty-nine patients with inguinal hernia were enrolled in this clinical
trial. Study was done in Milad and Rasoul Akram hospitals in Tehran, Iran,
during 2008-2010. The patients neither were pregnant nor did they have any signs of
peritonitis, strangulation, perforation or infection. Moreover, they had a Body
Mass Index (BMI) below 35 kg/m2 and were physically fit for general anesthesia. The
participants were divided into two groups by block randomization. The first (20) and the second (19) groups of patients underwent
laparoscopic herniorrhaphy in Trendelenburg and reverse-Trendelenburg positions.
Respectively all the operations were performed by one surgeon. The patients were
visited one day and one week after the surgery.
Results : Most frequent complications were rupture in peritoneal repair in 9 patients (23%), skin site bleeding in one
patient (2.6%), and peritoneal tension in 33 patients (84.6%) patients. Duration of surgery and peritoneal repair took a significantly
longer time in Trendelenburg versus the reverse-Trendelenburg position. There were
no differences in duration for returning to work or resumption of daily activities
between the two groups. Pain in the first day following surgery was
statistically more severe in the Trendelenburg group.
Conclusion: This
study demonstrated that reverse-Trendelenburg position took less time for herniorrhaphy
and peritoneal repair than Trendelenburg position, although the complications
were the same.
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