Saber Aly, Ellabban Goda M, Gad Mohammad A, Elsayem Karam
Department of General Surgery, Port-Fouad General Hospital, Port-Fouad, Port-Said, Egypt.
BMC Surg. 2012 Oct 30;12:22. doi: 10.1186/1471-2482-12-22.
Inguinal herniorrhaphy remains one of the most common general surgical operations, with approximately 15% performed for recurrence. The repair of the resulting recurrent hernia is a daunting task because of already weakened tissues and obscured and distorted anatomy. The aim of this study is to compare the posterior preperitoneal versus anterior tension-free approach for repair of unilateral recurrent inguinal hernia regarding complications and early recurrence.
120 Patients in this study were divided randomly into 2 main groups; Group A patients were subjected to posterior preperitoneal approach and those of group B were subjected to conventional anterior tension-free repair. The primary end point was recurrence and the secondary end points were time off from work, postoperative pain, scrotal swelling and wound infections.
The mean hospital stay was 1.2 days and 4.7, the mean time to return work was 8.2 and 11.2 days and the mean time off from work was 9.4 and 15.9 days in group A and B respectively. The maximum follow-up period was 48 months and the minimum was 14 months with a mean value as 37.11 ± 5.14 months. Only 2 recurrences (3.3%) in group A and 4 cases (6.25%) in group B were seen. The final pain score per patient and the overall complication rate were higher in group B.
The open preperitoneal repair offers the advantages of low recurrence rate and allows covering all potential defects with one piece of mesh and is far superior to the anterior approach.
ACTRN12611000337976.
腹股沟疝修补术仍然是最常见的普通外科手术之一，约15%的手术是针对复发性疝进行的。由于组织已经薄弱以及解剖结构模糊和变形，修复由此产生的复发性疝是一项艰巨的任务。本研究的目的是比较腹膜前修补术与前路无张力修补术治疗单侧复发性腹股沟疝的并发症和早期复发情况。
本研究中的120例患者随机分为2个主要组；A组患者采用腹膜前修补术，B组患者采用传统的前路无张力修补术。主要终点是复发，次要终点是误工时间、术后疼痛、阴囊肿胀和伤口感染。
A组和B组的平均住院时间分别为1.2天和4.7天，平均恢复工作时间分别为8.2天和11.2天，平均误工时间分别为9.4天和15.9天。最长随访期为48个月，最短为14个月，平均值为37.11±5.14个月。A组仅见2例复发（3.3%），B组见4例（6.25%）。B组患者的最终疼痛评分和总体并发症发生率更高。
开放腹膜前修补术具有复发率低的优点，并且可以用一块补片覆盖所有潜在缺损，远优于前路修补术。
ACTRN12611000337976。
