Cambal M, Zonca P, Hrbaty B
1st Department of Surgery, Comenius University, Bratislava, Slovakia.
Bratisl Lek Listy. 2012;113(2):103-7. doi: 10.4149/bll_2012_024.
Comparison of self-gripping mesh with fibrin-glue mesh fixation for laparoscopic hernia repair using TAPP technique.
The trial has a prospective randomized design. The primary end-point was the evaluation of pain at 2 days, 1 month, and 3 months after surgery. The pain occurring 3 months after the surgery was considered as chronic pain.
We have compared a group of 50 patients with self-gripping mesh with a group of 50 patients with fibrin glue mesh fixation using TAPP technique. There was no statistical difference between the basic group parameters (sex distribution, average age). There was no significant difference between the groups in terms of postoperative pain 1 month and 3 months after the surgery (p>0.05). There was no patient with chronic pain at 3-month follow-up in our trial. The mean operation time was 44 minutes in the group with self-gripping mesh and 48.5 minutes in the group with fibrin glue mesh fixation. There was a significant difference between both groups (p=0.006)
Both fixation methods appear to be a well-tolerated alternative to classical methods for mesh fixation with clips. According to our trial there is no difference in the postoperative pain incidence in self-gripping mesh and fibrin glue mesh fixation groups for laparoscopic hernia repair. Our data has showed that self-gripping mesh represents a tendency to a faster technique in comparison with fibrin-glue fixation. Both techniques are easy-to-use. There is no superior technique according to our trial (Tab. 2, Fig. 2, Ref. 23).
比较自固定补片与纤维蛋白胶补片固定用于经腹腔腹膜前疝修补术（TAPP）的效果。
本试验采用前瞻性随机设计。主要终点是评估术后2天、1个月和3个月时的疼痛情况。术后3个月出现的疼痛被视为慢性疼痛。
我们将一组50例使用自固定补片的患者与一组50例使用纤维蛋白胶补片固定并采用TAPP技术的患者进行了比较。两组基本参数（性别分布、平均年龄）之间无统计学差异。两组在术后1个月和3个月时的疼痛情况无显著差异（p>0.05）。在我们的试验中，3个月随访时没有患者出现慢性疼痛。自固定补片组的平均手术时间为44分钟，纤维蛋白胶补片固定组为48.5分钟。两组之间存在显著差异（p=0.006）。
两种固定方法似乎都是传统夹闭补片固定方法耐受性良好的替代方法。根据我们的试验，自固定补片组和纤维蛋白胶补片固定组在腹腔镜疝修补术后的疼痛发生率没有差异。我们的数据表明，与纤维蛋白胶固定相比，自固定补片的技术操作倾向于更快。两种技术都易于使用。根据我们的试验，没有哪种技术更具优势（表2，图2，参考文献23）。
