评估轻质或重质补片对腹股沟疝修补术后慢性疼痛影响的随机临床试验。

Randomized clinical trial assessing impact of a lightweight or heavyweight mesh on chronic pain after inguinal hernia repair.

作者信息

O'Dwyer P J, Kingsnorth A N, Molloy R G, Small P K, Lammers B, Horeyseck G

机构信息

Western Infirmary, Glasgow, Sunderland, UK.

出版信息

Br J Surg. 2005 Feb;92(2):166-70. doi: 10.1002/bjs.4833.

DOI:10.1002/bjs.4833

PMID:15584057

Abstract

BACKGROUND

Severe chronic pain is a long-term problem that may occur after inguinal hernia repair. The aim of this randomized study was to compare pain of any severity at 12 months after inguinal hernia repair with a partially absorbable lightweight mesh (LW group) or with a non-absorbable heavyweight mesh (HW group).

METHODS

Patients were assessed for pain at 1, 3 and 12 months by questionnaire, and were examined clinically at 12 months.

RESULTS

Some 321 patients were included in an intention-to-treat analysis, 162 in the LW group and 159 in the HW group. At 12 months, significantly fewer patients in the LW group than in the HW group had pain of any severity: 39.5 versus 51.6 per cent (difference-12.1 (95 per cent confidence interval-23.1 to-1.0) per cent; P = 0.033). The recurrence rate was higher in the LW group (5.6 versus 0.4 per cent; P = 0.037). Five of eight recurrences in LW group were associated with a single participating centre.

CONCLUSION

Use of lightweight mesh was associated with less chronic pain but an increase in hernia recurrence after inguinal hernia repair. The latter may be related to technical factors associated with fixation of such meshes rather than any inherent defect in the mesh.

摘要

背景

严重慢性疼痛是腹股沟疝修补术后可能出现的长期问题。本随机研究的目的是比较腹股沟疝修补术后12个月时，使用部分可吸收轻质补片（LW组）或不可吸收重质补片（HW组）的患者出现任何严重程度疼痛的情况。

方法

通过问卷调查对患者在1、3和12个月时的疼痛情况进行评估，并在12个月时进行临床检查。

结果

约321例患者纳入意向性分析，LW组162例，HW组159例。12个月时，LW组中出现任何严重程度疼痛的患者明显少于HW组：分别为39.5%和51.6%（差值-12.1（95%置信区间-23.1至-1.0）%；P = 0.033）。LW组的复发率更高（5.6%对0.4%；P = 0.037）。LW组8例复发中有5例与单个参与中心有关。