Liu Yiting, Shen Yingmo, Chen Jie
The Third Clinical Medical School of Capital Medical University, Beijing, China.
Department of Hernia and Abdominal Wall Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Minerva Chir. 2017 Aug;72(4):311-316. doi: 10.23736/S0026-4733.16.07258-8. Epub 2016 Dec 22.
Tension-free hernia repair has been recognized as the gold standard for the treatment of inguinal hernia. Different mesh has different characteristics that influence the efficiency of surgery. We conducted this study to evaluate the effectiveness of non-woven mesh in preperitoneal tension-free inguinal hernia repair under local anesthesia.
The medical records of patients who received preperitoneal tension-free inguinal hernia repair under local anesthesia in our hospital from 2012 to 2015 were reviewed. Patients were included if their surgery was conducted using non-woven or woven mesh. Outcome measures were operation time, length of stay in hospital, hospital fees, complications and degree of chronic pain, foreign body sensation and recurrence. A total of 389 cases were included. 186 cases were repaired with non-woven mesh (observation group), and 203 cases were repaired with woven mesh (control group).
There were no significant differences in operation time and length of stay in the hospital, but hospital fees were significantly higher in the observation group. Seroma of the inguinal region occurred in 6 cases of the observation group and 8 cases of the control group with no significant difference and no other complications and recurrence in both groups. No cases of chronic pain were recorded in the observation group; 8 cases were recorded in the control group. Foreign body sensation was found in 1 case of the observation group and 9 cases in the control group, which showed attractive advantages of non-woven mesh.
Preperitoneal tension-free repair for inguinal hernia under local anesthesia using non-woven or woven mesh is available. The hospital cost of using non-woven mesh is higher than that of woven mesh, but the incidence rate of chronic pain and foreign body sensation are lower in the use of non-woven mesh. Therefore, non-woven mesh may be worth using in the clinical setting.
无张力疝修补术已被公认为腹股沟疝治疗的金标准。不同的补片具有不同特性，会影响手术效果。我们开展本研究以评估非编织补片在局部麻醉下腹膜前无张力腹股沟疝修补术中的有效性。
回顾性分析2012年至2015年在我院接受局部麻醉下腹膜前无张力腹股沟疝修补术患者的病历。若手术使用非编织或编织补片则纳入研究。观察指标包括手术时间、住院时间、住院费用、并发症以及慢性疼痛程度、异物感和复发情况。共纳入389例患者。186例采用非编织补片修补（观察组），203例采用编织补片修补（对照组）。
手术时间和住院时间两组间无显著差异，但观察组住院费用显著更高。观察组6例出现腹股沟区血清肿，对照组8例出现，差异无统计学意义，两组均无其他并发症及复发。观察组未记录到慢性疼痛病例；对照组记录到8例。观察组1例出现异物感，对照组9例出现，显示出非编织补片具有明显优势。
局部麻醉下腹膜前无张力修补腹股沟疝可使用非编织或编织补片。使用非编织补片的住院费用高于编织补片，但使用非编织补片时慢性疼痛和异物感的发生率较低。因此，非编织补片在临床应用中可能值得采用。
