Patchayappan Manikandan, Narayanasamy Sangara Narayanan, Duraisamy Nagarajan
Department of General Surgery, Thanjavur Medical College and Hospital, Thanjavur, Tamil Nadu, India.
Department of General Surgery, Stanley Medical College and Hospital, Chennai, Tamil Nadu, India.
Avicenna J Med. 2015 Oct-Dec;5(4):106-9. doi: 10.4103/2231-0770.166891.
To analyze mesh fixation with minimum sutures and postoperative complications.
Prospective study.
Department of General Surgery, Thanjavur Medical College and Hospital, Tamil Nadu, from July 2010 to June 2012.
All inguinal hernia patients, who fulfilled the sample selection criteria, were admitted and planned for surgery. The prolene mesh is fashioned as in Lichtenstein's repair, placed and fixed only by three prolene stitches. The first stitch is made in the periosteum of pubic tubercle. The second stitch is taken in the inguinal ligament (1.5 cm lateral to the pubic tubercle) and the third stitch is from the medial most part of the conjoint tendon, that is, the mesh is fixed in the medial aspect alone.
Majority of the patients fall between the age group of 40 and 60 (72%) years and all are male patients. Of the total cases, 50% were right sided, 25% were left sided, and 25% were bilateral. Of the postoperative complications, 12% had seroma, 4% had hematoma, 2% developed surgical site infection, 2% developed chronic groin pain, 1% presented with recurrence, and none developed foreign body sinus.
The incidence of long-term complications of three stitch hernioplasty are comparable to that of the other standard, tension-free open hernia repair as well as other laparoscopic procedures. Moreover, the three stitch hernioplasty method is a simple method, easy for the beginners to adopt, has less foreign body reaction, less time consuming, causes less tissue trauma, and lesser chance for vascular injury.
分析用最少缝线进行补片固定及术后并发症情况。
前瞻性研究。
坦贾武尔医学院及医院普通外科,泰米尔纳德邦,2010年7月至2012年6月。
所有符合样本选择标准的腹股沟疝患者入院并计划接受手术。普理灵补片按利chtenstein修补术的方式制作,仅用三根普理灵缝线放置并固定。第一针缝在耻骨结节骨膜上。第二针缝在腹股沟韧带(耻骨结节外侧1.5厘米处),第三针从联合腱最内侧部分穿出,即补片仅在内侧固定。
大多数患者年龄在40至60岁之间(72%),且均为男性患者。在所有病例中,50%为右侧,25%为左侧,25%为双侧。术后并发症方面,12%出现血清肿,4%出现血肿,2%发生手术部位感染,2%出现慢性腹股沟疼痛,1%复发,无人出现异物窦。
三针疝修补术的长期并发症发生率与其他标准的无张力开放式疝修补术以及其他腹腔镜手术相当。此外,三针疝修补术方法简单,初学者易于采用,异物反应少,耗时少,组织创伤小,血管损伤几率小。