Paajanen Hannu
Department of Surgery, Mikkeli Central Hospital, Finland.
Hernia. 2002 Mar;6(1):26-8. doi: 10.1007/s10029-002-0048-2.
Chronic inguinal pain occurs in 20-30% of patients after hernia surgery. A prospective randomized study of 162 patients was undertaken to determine whether absorbable sutures cause less pain than continuous polypropylene fixation of the mesh in the Lichtenstein operation. All patients were operated on under local anesthesia by the same senior surgeon. One-half of the meshes were fixed with continuous 2-0 Dexon II sutures and one-half with continuous 2-0 Prolene sutures. The incidence of pain and recurrence was investigated after a mean follow-up of 2 years. Patient characteristics and operative outcome were similar in the two groups and statistically nonsignificant in both. The rate of significant wound hematomas (n = 3), infections (n = 1), and recurrences (n = 2) were low and not related to the type of sutures. In both study groups 24-26% of the patients felt some pain in follow-up, but over 90% were very satisfied with the operation. The absorbable suture material does not appear to cause less neuropathic pain after Lichtenstein operation than nonabsorbable sutures.
疝气手术后，20%至30%的患者会出现慢性腹股沟疼痛。一项针对162名患者的前瞻性随机研究旨在确定在Lichtenstein手术中，可吸收缝线是否比连续聚丙烯固定补片引起的疼痛更少。所有患者均由同一位资深外科医生在局部麻醉下进行手术。一半的补片用连续的2-0 Dexon II缝线固定，另一半用连续的2-0 Prolene缝线固定。平均随访2年后，对疼痛和复发的发生率进行了调查。两组患者的特征和手术结果相似，且在统计学上均无显著差异。严重伤口血肿（n = 3）、感染（n = 1）和复发（n = 2）的发生率较低，且与缝线类型无关。在两个研究组中，24%至26%的患者在随访中感到有些疼痛，但超过90%的患者对手术非常满意。与不可吸收缝线相比，可吸收缝合材料在Lichtenstein手术后似乎不会引起更少的神经性疼痛。
