Smietański M, Bigda J, Zaborowski K, Worek M, Sledziński Z
Department of General and Endocrine Surgery and Transplantation, Medical University of Gdańsk, ul. Debinki 7, 80-211, Gdańsk, Poland.
Hernia. 2009 Jun;13(3):239-42. doi: 10.1007/s10029-008-0465-y. Epub 2009 Jan 20.
This prospective cohort study evaluated whether partially absorbable monofilament mesh could influence postoperative pain and time of the return to normal activity while not increasing recurrence in modified Lichtenstein inguinal hernioplasty.
Two hundred and forty-two patients were operated on using poliglecaprone/polypropylene mesh. A modified Lichtenstein technique was used (more stitches and larger margin of mesh on the inguinal ligament, additional suture near the pubic bone). Follow-up data were collected at 3 years. The objective was to assess the incidence of late persistent postoperative pain and the recurrence rate.
The follow-up rate reached 88.37%. The recurrence rate was 2.2% (four patients). All recurrences appeared within the first 12 months. Slight discomfort, feelings of stiffness, and the occasional appearance of foreign bodies that did not influence daily activity were noted in 20 patients (10.8%). Chronic pain was found in 22 patients (11.1%), but only affected the daily activities of seven (3.24%). Only one patient suffering from pain described it as stronger than before the operation.
The use of partially absorbable light mesh reduces postoperative pain at long-term follow-up. The recurrence rate was not increased at 36 months follow-up.
这项前瞻性队列研究评估了在改良Lichtenstein腹股沟疝修补术中，部分可吸收单丝补片是否会影响术后疼痛和恢复正常活动的时间，同时又不增加复发率。
242例患者接受了聚乙醇酸/聚丙烯补片手术。采用改良Lichtenstein技术（更多缝线，补片在腹股沟韧带上的边缘更大，在耻骨附近增加缝合）。在3年时收集随访数据。目的是评估术后晚期持续疼痛的发生率和复发率。
随访率达到88.37%。复发率为2.2%（4例患者）。所有复发均出现在最初12个月内。20例患者（10.8%）出现轻微不适、僵硬感以及偶尔出现不影响日常活动的异物感。发现22例患者（11.1%）有慢性疼痛，但仅7例（3.24%）影响日常活动。只有1例疼痛患者称疼痛比手术前更严重。
长期随访显示，使用部分可吸收轻质补片可减轻术后疼痛。在36个月的随访中复发率未增加。
