Department of Surgery, Division of General Surgery, Medical College Of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA.
Surg Endosc. 2018 Mar;32(3):1160-1164. doi: 10.1007/s00464-017-5787-3. Epub 2017 Aug 24.
Several synthetic meshes are available to reinforce the inguinal region following laparoscopic hernia reduction. We sought to compare postoperative pain of patients who underwent laparoscopic inguinal herniorrhaphy using self-adhering polyester mesh to those who had non-adhering, synthetic mesh implanted using absorbable tacks.
This study is a retrospective review of patients who underwent primary laparoscopic inguinal herniorrhaphy at the Medical College of Wisconsin between October 2012 and July 2014. Clinical information and perioperative pain scores using the visual analog scale (VAS) were obtained to evaluate immediate pre and postoperative pain.
A total of 98 patients (88 male) underwent laparoscopic inguinal herniorrhaphy during the study interval. Forty-two patients received self-adhering mesh and 56 patients received mesh secured with tacks. Patient demographics and comorbidities did not differ significantly between the two groups. There was no difference in preoperative VAS scores between groups. The self-adhering mesh patients had a lower mean VAS change score (less pain). Postoperative complications did not differ between groups apart from a higher observed incidence of seroma in the self-adhering mesh group (p = 0.04). No hernias recurred in either group during the study interval.
Self-adhering mesh in laparoscopic inguinal herniorrhaphy resulted in less immediate postoperative pain than tacked mesh as demonstrated by VAS score. Postoperative complications were similar between the two groups. The results of this study demonstrate that laparoscopic inguinal herniorrhaphy using self-adhering mesh is comparable to tacked mesh in regards to short-term complication rates, but show a favorable advantage in regards to immediate postoperative pain.
有几种合成网片可用于加强腹腔镜疝修补术后的腹股沟区域。我们旨在比较使用自粘聚酯网片进行腹腔镜腹股沟疝修补术与使用可吸收钉固定非粘网片的患者术后疼痛。
本研究为 2012 年 10 月至 2014 年 7 月期间在威斯康星医学院行原发性腹腔镜腹股沟疝修补术患者的回顾性研究。获取临床信息和使用视觉模拟量表（VAS）的围手术期疼痛评分，以评估即刻术前和术后疼痛。
研究期间共有 98 例（88 例男性）患者行腹腔镜腹股沟疝修补术。42 例患者接受自粘网片，56 例患者接受钉固定网片。两组患者的人口统计学和合并症无显著差异。两组间术前 VAS 评分无差异。自粘网片患者的平均 VAS 变化评分（疼痛减轻）较低。两组间术后并发症无差异，但自粘网片组观察到更高的血清肿发生率（p=0.04）。研究期间两组均无疝复发。
与钉固定网片相比，腹腔镜腹股沟疝修补术中使用自粘网片可减轻即刻术后疼痛，VAS 评分证实了这一点。两组间术后并发症相似。本研究结果表明，在短期并发症发生率方面，腹腔镜腹股沟疝修补术使用自粘网片与钉固定网片相当，但在即刻术后疼痛方面具有明显优势。
