随机临床试验比较了轻量网片与重量型网片在原发性腹股沟疝修补术中的应用。

Randomized clinical trial comparing lightweight mesh with heavyweight mesh for primary inguinal hernia repair.

机构信息

Sina Hospital, Tehran University of Medical Sciences, P.O. Box 13185-1678, Tehran, Iran.

出版信息

Hernia. 2013 Aug;17(4):471-7. doi: 10.1007/s10029-012-1009-z. Epub 2012 Nov 9.

Abstract

PURPOSE

The aim of the present randomized clinical trial was to compare feeling of a foreign body and the early and late outcomes after inguinal hernia repair with the heavyweight (HW) mesh and lightweight (LW) mesh during a 12-month follow-up at a single specialist center.

MATERIALS AND METHODS

One hundred and ten patients were randomized into HW and LW mesh groups, both of which underwent unilateral primary inguinal hernia via the Lichtenstein technique. At each postoperative visit, any complication, recurrence, feeling of a foreign body, quality of life, residual pain, and numbness were recorded.

RESULTS

Complaint of feeling of a foreign body on the repaired side was more frequent in the HW mesh group than in the LW mesh group (P < 0.05). Fewer patients in the LW mesh group reported postoperative numbness around the groin or down the thigh than did those in the HW mesh group (P < 0.05). At 12-month follow-up, however, there was no difference between the LW and HW mesh groups as regards the incidence or severity of pain or discomfort and recurrence rate and nor was there any significant dissimilarity between the two study groups in any dimension of quality of life on the SF-36.

CONCLUSION

There was no significant difference between our LW mesh and HW mesh groups in terms of chronic pain incidence, recurrence rate, and quality of life following inguinal hernia repair. However, fewer patients in the LW mesh group reported numbness around the groin or down the thigh postsurgery than did those in the HW mesh group and therein may lie in the superiority of LW mesh for inguinal hernia repair. Larger cohort studies with longer follow-up periods are required to elucidate in the future the benefits of the LW mesh.

摘要

目的

本随机临床试验的目的是比较在单中心 12 个月随访时,使用重质(HW)网片和轻质(LW)网片行腹股沟疝修补术后异物感以及早期和晚期结果。

材料和方法

110 例患者随机分为 HW 网片组和 LW 网片组,两组均行单侧原发性腹股沟疝经 Lichtenstein 技术修补。每次术后随访时,记录任何并发症、复发、异物感、生活质量、残余疼痛和麻木。

结果

HW 网片组修复侧异物感的发生率高于 LW 网片组(P<0.05)。LW 网片组腹股沟或大腿下术后麻木的患者少于 HW 网片组(P<0.05)。然而,在 12 个月的随访中,LW 网片组和 HW 网片组在疼痛或不适的发生率或严重程度以及复发率方面没有差异,在 SF-36 的任何生活质量维度上也没有明显差异。

结论

LW 网片和 HW 网片组在腹股沟疝修补术后慢性疼痛发生率、复发率和生活质量方面无显著差异。然而,LW 网片组术后腹股沟或大腿下麻木的患者少于 HW 网片组,这可能表明 LW 网片在腹股沟疝修补术中具有优势。需要进行更大的队列研究和更长的随访时间,以阐明 LW 网片的优势。

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