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在李金斯坦腹股沟疝修补术中使用吻合器进行补片固定:并发症更少,复发率更低。

Mesh fixation using staples in Lichtenstein's inguinal hernioplasty: fewer complications and fewer recurrences.

作者信息

van der Zwaal P, van den Berg I R, Plaisier P W, Tutein Nolthenius R P

机构信息

Department of Surgery, Albert Schweitzer Hospital, 3300 AK, Dordrecht, The Netherlands.

出版信息

Hernia. 2008 Aug;12(4):391-4. doi: 10.1007/s10029-008-0353-5. Epub 2008 Feb 20.

Abstract

BACKGROUND

Fixation of the mesh in Lichtenstein's inguinal hernioplasty is traditionally performed with polypropylene sutures. A modification of this technique uses staples for securing of the mesh.

METHOD

A retrospective comparative study of 149 elective repairs of a primary inguinal hernia was performed: a control group of 67 patients undergoing mesh fixation using sutures and a study group of 82 patients undergoing staple fixation. Operating time, recurrence, postoperative pain, complications and costs were studied.

RESULTS

Seven recurrences (11%) occurred in the polypropylene group as compared to one recurrence (1%) in the staple group (P < 0.01). There was a trend of fewer complications in the staple group. Operative time and long-term postoperative pain did not differ significantly between the two groups. The costs per surgery for mesh fixation and skin closure were euro 11.13 for the suture group and euro 24.35 for the staple group.

CONCLUSION

Staple fixation of the mesh in Lichtenstein's inguinal hernioplasty can be considered equal to traditional fixation with sutures with regard to operating time and postoperative pain. However, staple fixation seems to show fewer recurrences and fewer complications.

摘要

背景

在李金斯坦腹股沟疝修补术中,传统上使用聚丙烯缝线固定补片。该技术的一种改良方法是使用吻合器固定补片。

方法

对149例原发性腹股沟疝择期修补术进行回顾性比较研究:67例患者组成的对照组采用缝线固定补片,82例患者组成的研究组采用吻合器固定。研究了手术时间、复发情况、术后疼痛、并发症和费用。

结果

聚丙烯缝线组发生7例复发(11%),而吻合器组发生1例复发(1%)(P < 0.01)。吻合器组并发症有减少趋势。两组手术时间和长期术后疼痛无显著差异。缝线组补片固定和皮肤缝合的每次手术费用为11.13欧元,吻合器组为24.35欧元。

结论

在李金斯坦腹股沟疝修补术中,就手术时间和术后疼痛而言,吻合器固定补片可被视为与传统缝线固定相当。然而,吻合器固定似乎复发较少且并发症较少。

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