Hayashi Yuki, Miyata Kanji, Yuasa Norihiro, Takeuchi Eiji, Goto Yasutomo, Miyake Hideo, Nagai Hidemasa, Kobayashi Yoichiro
Department of Surgery, Japanese Red Cross Nagoya Dai-ichi Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, Japan,
Surg Today. 2014 Dec;44(12):2255-62. doi: 10.1007/s00595-014-0867-7. Epub 2014 Feb 20.
Tension-free mesh repair of adult inguinal hernias has become a standard procedure, but there have been few comparisons of the postoperative outcome after hernia repair using the Prolene Hernia System (PHS) vs. the Mesh Plug (MP) method in a large number of patients from a single institution.
We reviewed the medical records of patients to investigate the short- and long-term outcomes of the different types of hernia repair. Late symptoms were evaluated by questionnaire. A total of 1,141 repairs performed from 1999 to 2008 (PHS in 957 and MP in 184 repairs) were evaluated.
There were 93 early postoperative complications (8.2%). A subcutaneous hematoma was found more frequently after MP repair compared with after PHS repair (3.8 vs. 1.3%, P = 0.013). Seven hundred and ten patients (62.2%) could be followed up for more than 2 years. Recurrence was detected in 14 patients with PHS repair and two patients with MP repair (1.5 vs. 1.1%, P = 0.956). Wound infections occurred in three patients (0.3%) with PHS repair vs. none with MP repair (P > 0.999). Patients with PHS and MP repair showed no significant differences in the long-term wound pain.
The recurrence and wound infection rates were similar after hernia repair using the PHS and MP methods. Patients undergoing PHS repair developed fewer subcutaneous hematomas. An older age (≥65 years) was a significant independent risk factor for recurrence.
成人腹股沟疝的无张力疝修补术已成为一种标准术式,但在单机构大量患者中,使用普理灵疝修补系统(PHS)与网塞(MP)法进行疝修补术后的结果比较较少。
我们回顾了患者的病历,以研究不同类型疝修补术的短期和长期结果。通过问卷调查评估晚期症状。对1999年至2008年进行的1141例修补术(957例PHS修补术和184例MP修补术)进行了评估。
术后早期并发症有93例(8.2%)。与PHS修补术后相比,MP修补术后皮下血肿的发生率更高(3.8%对1.3%,P = 0.013)。710例患者(62.2%)获得了超过2年的随访。PHS修补术组有14例患者复发,MP修补术组有2例患者复发(1.5%对1.1%,P = 0.956)。PHS修补术组有3例患者发生伤口感染(0.3%),MP修补术组无伤口感染发生(P > 0.999)。PHS修补术和MP修补术患者在长期伤口疼痛方面无显著差异。
使用PHS和MP方法进行疝修补术后的复发率和伤口感染率相似。接受PHS修补术的患者皮下血肿较少。年龄较大(≥65岁)是复发的一个显著独立危险因素。