Department of General Surgery, Akdeniz University Medical School, 07070, Antalya, Turkey.
Surg Today. 2012 Jan;42(2):157-63. doi: 10.1007/s00595-011-0017-4. Epub 2011 Nov 3.
An inguinal hernia is a common pathology that can be treated using several different surgical procedures. Although there have been many studies comparing the clinical results of these techniques, there has so far been no digital analysis of the alterations developing secondary to pain with regard to the muscle functions of the lower extremities. This prospective randomized trial was designed to compare this aspect for subjects treated using the laparoscopic techniques and those treated using the conventional method.
A total of 75 patients, 25 of whom who had undergone hernia repair using the total extraperitoneal technique, 25 of whom who had undergone repair using the transabdominal preperitoneal technique, and 25 who had undergone repair using the Prolene mesh graft technique, were evaluated preoperatively and on the third postoperative day by isometric and isokinetic measurements, the visual analog score (VAS), the necessity of postoperative analgesia, complications, and the time that had elapsed before returning to work, and these results were recorded.
Hernia repair using the conventional method led to an average of 3 times more muscle function loss compared with the laparoscopic techniques, and this difference was shown to be statistically significant. The VAS, postoperative complications, and time elapsed before returning to work were lower for laparoscopic surgeries and also were compatible with the findings described in the previous literature.
Use of a digital environment with numerical parameters and measurements recorded using a dynamometer demonstrated that in the early postoperative period and on the third postoperative day, open surgery causes more functional loss in the lower extremities than laparoscopic methods. Therefore, surgeons should use laparoscopic methods whenever possible to reduce both pain and loss of muscle function.
腹股沟疝是一种常见的疾病，可以通过多种不同的手术方法进行治疗。尽管已经有许多研究比较了这些技术的临床效果，但迄今为止，还没有针对与下肢肌肉功能相关的疼痛引起的变化进行数字分析。本前瞻性随机试验旨在比较使用腹腔镜技术和传统方法治疗的患者在这方面的差异。
共纳入 75 例患者，其中 25 例采用完全腹膜外技术进行疝修补术，25 例采用经腹腹膜前技术进行修补术，25 例采用 Prolene 网片修补术。所有患者分别在术前和术后第 3 天进行等长和等速测量、视觉模拟评分（VAS）、术后镇痛需求、并发症以及恢复工作时间，并记录这些结果。
与腹腔镜技术相比，传统方法导致的肌肉功能丧失平均增加了 3 倍，且差异具有统计学意义。腹腔镜手术的 VAS、术后并发症和恢复工作时间均较低，与先前文献中的描述一致。
使用数字环境和测力计记录的数值参数和测量结果表明，在术后早期和第 3 天，开放手术导致下肢功能丧失比腹腔镜方法更多。因此，外科医生应尽可能使用腹腔镜方法，以减轻疼痛和肌肉功能丧失。
