Bankstown-Lidcombe Hospital, University of New South Wales, Bankstown, NSW, 2200, Australia,
Hernia. 2013 Dec;17(6):709-17. doi: 10.1007/s10029-012-1034-y. Epub 2013 Jan 24.
Endoscopic repair of inguinal hernia can decrease the incidence of chronic groin pain. Staple mesh fixation is the surgical technique preferentially used but may also cause residual pain. Although a substantial number of specialists advocate no mesh fixations, concerns are that this could lead to an increase in recurrence rates. This study aimed to assess the safety and the effectiveness of fibrin sealant, as an alternative technique to staple mesh fixation after totally extraperitoneal (TEP) inguinal hernia repair.
A total of 472 patients underwent elective TEP inguinal hernia repair between February 2005 and July 2011. Mesh fixation was achieved using fibrin sealant. Patients were reviewed postoperatively at Week 2, Week 6, and Month 6. Patient satisfaction was assessed in a subgroup of 116 patients using a comprehensive scoring system designed for hernia repairs, and pain was assessed using a standard Visual Analog pain Scale.
No conversion to open surgery was observed. There were two cases of major morbidities and no mortality. Three months after surgery, only three patients (0.6 %) experienced chronic groin or testicular discomfort. At Week 6, 98.9 % of the patients were either satisfied or very satisfied with their outcome, and 96.8 % denied any residual pain. Finally, only six hernia recurrences (0.9 %) were reported, of which five occurred during the first months of the study.
Fibrin sealant is safe and reliable for mesh fixation of inguinal hernia during TEP repair with a very high satisfaction index and limited risk of developing chronic pain.
经腹腹膜前修补术（TEP）治疗腹股沟疝可降低慢性腹股沟疼痛的发生率。钉合固定网片是首选的手术技术，但也可能导致残余疼痛。尽管相当多的专家主张不固定网片，但人们担心这可能会导致复发率增加。本研究旨在评估纤维蛋白胶作为 TEP 腹股沟疝修补术后替代钉合固定网片的技术的安全性和有效性。
2005 年 2 月至 2011 年 7 月，共 472 例患者接受择期 TEP 腹股沟疝修补术。使用纤维蛋白胶进行网片固定。术后第 2、6 周和第 6 个月对患者进行复查。对 116 例患者进行了一项综合评分系统评估患者满意度，评估疼痛采用标准视觉模拟疼痛量表。
无中转开放手术。有 2 例严重并发症，无死亡病例。术后 3 个月，仅 3 例（0.6%）患者出现慢性腹股沟或睾丸不适。术后第 6 周，98.9%的患者对治疗结果满意或非常满意，96.8%的患者否认有残余疼痛。最后，仅报告了 6 例疝复发（0.9%），其中 5 例发生在研究的头几个月。
纤维蛋白胶在 TEP 修补术治疗腹股沟疝时用于固定网片是安全可靠的，具有很高的满意度指数和有限的慢性疼痛风险。
