Ayiomamitis Georgios D, Zaravinos Apostolos, Stathakis Panayiotis C, Kouroumpas Efstratios, Georgiades Phivos, Polymeneas George, Griniatsos John
2nd Department of Surgery, Tzanion General Hospital, Piraeus, Greece.
Surg Laparosc Endosc Percutan Tech. 2013 Aug;23(4):e150-5. doi: 10.1097/SLE.0b013e31828b830d.
The emphasis for research in inguinal hernia repair has shifted from hernia recurrence to groin pain, which is considered the most important factor for poor quality of life.
: To evaluate hernia recurrences and pain at trocar site and at inguinal hernia site, in patients who underwent tacks-free transabdominal preperitoneal inguinal hernia repair, using a lightweight nonfixed 3-dimensional mesh with peritoneal suturing.
Between 2009 and 2011, 32 patients (2 female) with mean age 51 years underwent hernia repair. The mean follow-up period was 12.4 months.
The mean operative time was 84 minutes. There was minimal blood loss. No bowel or urinary bladder injury had occurred. Mean hospital stay was 1 day. One patient developed seroma 4 months postoperatively. There were no conversions to open repair, no hernia recurrence, and no deaths. The mean value of pain at trocar site and inguinal hernia site 12 hours postoperatively was 1.469 and 0.875, respectively. The pain was more intense bearing a peak at 12 hours postoperatively at the trocar site, compared with the inguinal site.
It is demonstrated with this technique that there are no recurrences and the chronic pain is negligible. These findings call for confirmatory randomized trials in larger series with longer follow-up.
腹股沟疝修补术的研究重点已从疝复发转移至腹股沟疼痛,腹股沟疼痛被认为是生活质量低下的最重要因素。
评估采用轻质非固定三维补片及腹膜缝合技术进行免钉经腹腹膜前腹股沟疝修补术的患者,其套管针穿刺部位及腹股沟疝部位的疝复发情况和疼痛情况。
2009年至2011年期间,32例患者(2例女性)接受了疝修补术,平均年龄51岁。平均随访期为12.4个月。
平均手术时间为84分钟。出血量极少。未发生肠管或膀胱损伤。平均住院时间为1天。1例患者术后4个月出现血清肿。无中转开放手术病例,无疝复发,无死亡病例。术后12小时套管针穿刺部位及腹股沟疝部位的疼痛平均值分别为1.469和0.875。与腹股沟部位相比,套管针穿刺部位术后12小时疼痛更剧烈,达到峰值。
该技术表明无复发情况,慢性疼痛可忽略不计。这些发现需要在更大样本、更长随访期的验证性随机试验中得到证实。