Department of Surgery, Central Manchester Foundation NHS Trust, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK.
Hernia. 2012 Dec;16(6):647-53. doi: 10.1007/s10029-012-0936-z. Epub 2012 Jul 4.
The use of fibrin sealant (FS) (Tisseel™) for mesh fixation in patients undergoing laparoscopic groin hernia surgery is a well-recognised technique in Europe, but no study to date has examined effect on quality of life (QoL) on patients undergoing FS mesh fixation. A prospective study was therefore conducted to examine the effects on QoL of patients undergoing laparoscopic groin hernia surgery using FS in the United Kingdom.
Between March 2007 and January 2011, all patients undergoing laparoscopic total extra preperitoneal (TEP) groin hernia repair using FS were included in the study. A validated hernia questionnaire from The Royal College of Surgeons of England supplemented by the EORTC QLQ C-30 to assess the pre- and postoperative QoL, pain scores and health outcome measures was used. All the patient's demographics, duration of surgery, size of hernia, recurrence, morbidity and hospital stay were recorded.
Data from 92 patients (87 males and 5 females) with a median age of 46 years (range, 19-82 years) was collected for the study (response rate of 92/121, 73 %). A total of 58 patients (63 %) had a unilateral and 34 patients (37 %) a bilateral hernia repair, of which 6 (7 %) were recurrent inguinal hernia. The mean operating time for a unilateral hernia was 36 min (30-62), and that for a bilateral hernia was 59 min (51-83). There were no conversions to open surgery out of the 92 patients included with the recorded morbidity of 7 %. There were no early recurrences. Eighty-nine patients (98 %) of patients were discharged in the first 24 h after surgery. There was a significant statistical difference recorded in patients visual analogue pain score (VAS 0-10) before and after surgery (P < 0.0001, Mann-Whitney U test). The physical, emotional, social and health components of the questionnaire were statistically significant pre- and postoperatively (P < 0.001 Mann-Whitney U test).
Groin hernia TEP repair with FS fixation did not have a detrimental effect on QoL and pain scores. In addition, the low early recurrence rate provided good evidence of the mesh fixation properties of FS. FS can therefore be continued to be recommended, as an alternative fixation method in laparoscopic groin hernia surgery.
在接受腹腔镜腹股沟疝手术的患者中使用纤维蛋白密封剂（FS）（Tisseel™）固定网片是欧洲广泛认可的技术，但迄今为止尚无研究检查 FS 网片固定对患者生活质量（QoL）的影响。因此，进行了一项前瞻性研究，以检查英国使用 FS 进行腹腔镜腹股沟疝手术的患者的 QoL 影响。
2007 年 3 月至 2011 年 1 月期间，所有接受 FS 行腹腔镜全腹膜外（TEP）腹股沟疝修补术的患者均纳入研究。使用英国皇家外科学院的经过验证的疝问卷，辅以 EORTC QLQ C-30 评估术前和术后 QoL、疼痛评分和健康结果测量。记录所有患者的人口统计学数据、手术持续时间、疝的大小、复发、发病率和住院时间。
共收集了 92 名患者（87 名男性和 5 名女性）的数据进行研究（92/121，73%的应答率）。中位年龄为 46 岁（范围，19-82 岁）。共有 58 名患者（63%）接受了单侧疝修补术，34 名患者（37%）接受了双侧疝修补术，其中 6 名（7%）为复发性腹股沟疝。单侧疝的平均手术时间为 36 分钟（30-62），双侧疝的手术时间为 59 分钟（51-83）。92 名纳入患者中无转为开放手术，发病率为 7%。无早期复发。89 名患者（98%）术后 24 小时内出院。术后患者视觉模拟疼痛评分（VAS 0-10）有显著统计学差异（P < 0.0001，Mann-Whitney U 检验）。问卷的身体、情感、社会和健康成分在术前和术后均有统计学意义（P < 0.001，Mann-Whitney U 检验）。
FS 固定的腹股沟疝 TEP 修补术对 QoL 和疼痛评分没有不利影响。此外，低早期复发率为 FS 的网片固定特性提供了良好的证据。因此，FS 可以继续被推荐为腹腔镜腹股沟疝手术的替代固定方法。
