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新型轻质补片用于腹腔镜完全腹膜外腹股沟疝修补术的早期结果

Early results for new lightweight mesh in laparoscopic totally extra-peritoneal inguinal hernia repair.

作者信息

Khan L R, Kumar S, Nixon S J

机构信息

Department of Clinical and Surgical Sciences (Surgery), University of Edinburgh, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, Scotland.

出版信息

Hernia. 2006 Aug;10(4):303-8. doi: 10.1007/s10029-006-0093-3. Epub 2006 Jun 10.

Abstract

Prosthetic mesh reinforcement is now routine in the management of inguinal hernia but can cause considerable pain and stiffness around the groin. The aim of this study was to compare the outcome after laparoscopic TEP inguinal repair using new lightweight or traditional heavyweight mesh performed in a single unit. Between November 2004 and March 2005, 113 patients underwent laparoscopic TEP inguinal repair using either lightweight (28 g/m(2)) or heavyweight (85 g/m(2)) mesh. Follow-up data was obtained using case note review and telephone-based questionnaire in April 2005. Follow-up information was obtained for 93 (83%) out of 113 patients. There was no difference between the two groups in the incidence of pain/discomfort at mean 3-month follow-up (45 vs 41%, Mann-Whitney U, P=0.641). However, there was a significant inverse correlation between the length of time since operation and severity of pain/discomfort in the lightweight group (P=0.001, Pearson test), suggesting a faster speed of recovery with lightweight mesh. Laparoscopic TEP inguinal hernia repair with lightweight mesh yields promising early results. Whilst there was no significant difference in pain or recurrence in the short term, post-operative pain scores improved earlier in patients with lightweight mesh compared to heavyweight mesh. This merits further study, with larger cohorts and longer follow-up, to determine the benefits of lightweight mesh.

摘要

人工合成补片加固现已成为腹股沟疝治疗的常规方法,但可能会导致腹股沟周围出现相当程度的疼痛和僵硬。本研究的目的是比较在同一科室采用新型轻质补片或传统重质补片进行腹腔镜经腹膜前腹股沟疝修补术的效果。在2004年11月至2005年3月期间,113例患者接受了腹腔镜经腹膜前腹股沟疝修补术,分别使用了轻质(28 g/m²)或重质(85 g/m²)补片。2005年4月,通过查阅病例记录和电话问卷调查获取随访数据。113例患者中有93例(83%)获得了随访信息。在平均3个月的随访中,两组疼痛/不适的发生率没有差异(45%对41%,Mann-Whitney U检验,P = 0.641)。然而,轻质补片组术后时间与疼痛/不适严重程度之间存在显著的负相关(P = 0.001,Pearson检验),这表明轻质补片的恢复速度更快。采用轻质补片进行腹腔镜经腹膜前腹股沟疝修补术取得了良好的早期效果。虽然短期内疼痛或复发方面没有显著差异,但与重质补片相比,轻质补片组患者的术后疼痛评分改善得更早。这值得进一步研究,纳入更大的队列并进行更长时间的随访,以确定轻质补片的益处。

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