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采用新型轻质自固定网片行开放式无张力疝修补术:来自两家医疗机构的中期经验。

Open tension-free hernioplasty using a novel lightweight self-gripping mesh: medium-term experience from two institutions.

机构信息

Department of General Surgery, Clínica Universidad de Navarra, Pamplona, Spain.

出版信息

Langenbecks Arch Surg. 2012 Feb;397(2):291-5. doi: 10.1007/s00423-011-0831-6. Epub 2011 Aug 19.

DOI:10.1007/s00423-011-0831-6
PMID:21853420
Abstract

PURPOSE

The process of mesh fixation and the potential risk of associated chronic pain are always surgeon's main concerns in hernia surgery. A wide variety of lightweight mesh models are currently available on the market to overcome some of these problems showing good preliminary results, but no data representing the medium- or long-term results. The present study aims to report the clinical outcomes of two institutional series of patients who underwent hernia repair using a partially absorbable auto adherent mesh (Parietene™ Progrip™--PP).

METHODS

A prospective analysis was performed including unselected patients with primary groin hernia who underwent a standardized Lichtenstein procedure using the PP mesh at two tertiary institutions.

RESULTS

During the 2-year study period, 181 patients (167 males; 14 females) with a median age of 63 years (19-85 years) were operated on at both centers. Short-term complications occurred in 27 patients (15%), the most commonly seen being urinary retention (6%) followed by hematoma (5%) and acute orchitis (2%). With a median follow-up of 17 months (12-29 months), 4 patients (2%) had a feeling of a foreign body in the groin, and 7 (4%) developed chronic pain. A total of four patients (2%) developed recurrence.

CONCLUSIONS

In our experience, the use of the PP mesh for hernioplasties offers a potential benefit not only in the short-term period but also in a medium-term follow-up with low recurrence and late chronic pain rates. However, this particular mesh does not fully prevent all complications and chronic pain and recurrent hernias have been reported for the first time.

摘要

目的

在疝修补术中,网片固定过程及相关慢性疼痛的潜在风险一直是外科医生关注的主要问题。目前市场上有各种不同的轻质网片模型,旨在解决这些问题,这些模型初步结果较好,但缺乏中、长期结果的数据。本研究旨在报告使用部分可吸收自黏合网片(Parietene™ Progrip™-PP)行疝修补术的两机构系列患者的临床结果。

方法

对两家三级医疗机构的 181 例(167 例男性,14 例女性)原发性腹股沟疝患者进行前瞻性分析,这些患者均接受了标准化的 Lichtenstein 手术,并使用了 PP 网片。

结果

在 2 年的研究期间,两家中心共有 181 例(167 例男性,14 例女性)患者接受了手术,中位年龄为 63 岁(19-85 岁)。27 例(15%)患者出现短期并发症,最常见的是尿潴留(6%),其次是血肿(5%)和急性睾丸炎(2%)。中位随访时间为 17 个月(12-29 个月),4 例(2%)患者腹股沟有异物感,7 例(4%)慢性疼痛。共有 4 例(2%)患者复发。

结论

根据我们的经验,PP 网片用于疝修补术不仅在短期,而且在中期随访中都具有潜在的益处,复发率和迟发性慢性疼痛率较低。然而,这种特殊的网片并不能完全预防所有并发症和慢性疼痛,并且首次报道了复发和慢性疼痛的病例。

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[Use of adhesive mesh in hernioplasty compared to the conventional technique. Results of a randomised prospective study].[与传统技术相比,粘连性补片在疝修补术中的应用。一项随机前瞻性研究的结果]
Cir Esp. 2010 Oct;88(4):253-8. doi: 10.1016/j.ciresp.2010.06.008. Epub 2010 Sep 15.
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Self-fixating mesh for the Lichtenstein procedure--a prestudy.用于李金斯坦手术的自固定网片——一项预研究。
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Randomised clinical trial comparing lightweight mesh with heavyweight mesh for inguinal hernioplasty.
一种新型的带自固定网片的无缝合结肠吻合术:实验模型
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Lichtenstein technique for inguinal hernia repair using polypropylene mesh fixed with sutures vs. self-fixating polypropylene mesh: a prospective randomized comparative study.Lichtenstein 技术治疗腹股沟疝修补术:使用缝线固定的聚丙烯网片与自固定聚丙烯网片的前瞻性随机对照研究。
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Systematic review and meta-analysis of published randomized controlled trials comparing the role of self-gripping mesh against suture mesh fixation in patients undergoing open inguinal hernia repair.对已发表的随机对照试验进行系统评价和荟萃分析,比较自固定补片与缝合补片固定在开放腹股沟疝修补患者中的作用。
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