Chastan P
Polyclinique Bordeaux Rive Droite, Rue Edouard Herriot, 33310 Lormont, France.
Hernia. 2009 Apr;13(2):137-42. doi: 10.1007/s10029-008-0451-4. Epub 2008 Nov 13.
Lichtenstein tension-free mesh repair is the most commonly used technique for the open treatment of inguinal hernia. Mesh fixation and the potential risk of associated pain are always a surgical concern. The aim of this study was to report the initial clinical experience using an innovative, partly resorbable mesh with self-gripping properties.
Fifty-two patients (70 hernias) underwent open Lichtenstein hernia repair with Parietene Progrip (Sofradim Production, Trévoux, France-Group Covidien). Patient pain as measured by a visual analogue scale (VAS) was the primary study endpoint. Clinical evaluation, with careful attention to the identification of hernia recurrence, was performed at 1 month and 1 year. The evaluation of fixation precision, quality of fixation and ease of use was assessed by the primary surgeon.
The mean patient pain was 1.3 (+/-1.4) at discharge, 0.1 (+/-0.4) at 1 month and 0.0 (+/-0.1) (one patient with VAS 1/10) at 1 year, respectively. The mean operative time was 19 +/- 4 min. There was one minor cutaneous infection and no documented recurrence. The quality of the gripping effect was rated very good in 51 (98.1%) of the cases performed.
The use of a novel low-density, macroporous mesh with semi-resorbable self-fixing properties during tension-free repair may be a satisfactory solution to the clinical problems of pain and recurrence following inguinal herniorrhaphy.
Lichtenstein无张力疝修补术是腹股沟疝开放治疗中最常用的技术。补片固定及相关疼痛的潜在风险一直是外科手术关注的问题。本研究的目的是报告使用一种具有创新的、部分可吸收且自固定特性的补片的初步临床经验。
52例患者(70处疝)接受了使用Parietene Progrip(法国索弗拉丹生产公司,特雷武,法国-柯惠集团)进行的开放式Lichtenstein疝修补术。以视觉模拟评分法(VAS)测量的患者疼痛是主要研究终点。在1个月和1年时进行临床评估,仔细留意疝复发情况。由主刀医生评估固定精度、固定质量及易用性。
患者出院时平均疼痛评分为1.3(±1.4),1个月时为0.1(±0.4),1年时为0.0(±0.1)(1例患者VAS评分为1/10)。平均手术时间为19±4分钟。发生1例轻微皮肤感染,无复发记录。在51例(98.1%)手术病例中,抓持效果质量被评为非常好。
在无张力修补术中使用一种新型的低密度、大孔且具有半可吸收自固定特性的补片,可能是解决腹股沟疝修补术后疼痛和复发这两个临床问题的令人满意的方法。