Kalra Tarun, Soni Rajesh Kumar, Sinha Ajit
Junior Resident, Department of General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. India.
Professor, Department of General Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
J Clin Diagn Res. 2017 Aug;11(8):PC13-PC16. doi: 10.7860/JCDR/2017/27982.10478. Epub 2017 Aug 1.
Laparoscopic hernia repair is in vogue in the present era. Both the operating surgeon and the patient are concerned about the postoperative inguinodynia which has now replaced recurrence as the predominant factor affecting quality of life.
Our study aimed to compare early postoperative outcomes with the standard non absorbablepolypropylene and the newer partially absorbable composite meshes.
A total of 60 patients with unilateral uncomplicated inguinal hernia were included in the study and randomly divided into two groups, one each for one kind of mesh. Patients underwent Transabdominal Preperitoneal (TAPP) repair of hernia after taking written informed consent. Follow up was done in the immediate postoperative period and at three months. Patients were compared for inguinodynia, sensation of heaviness, seroma/haematoma formation and return to work activities. Standard statistical tests were applied and a p-value <0.05 was taken as significant.
Patients in the composite group complain of significantly less pain as compared to those with the non absorbable mesh at three months (p-value 0.003). They also report less sensation of heaviness over the groin area. However, incidence of seroma formation was higher in the composite group (20%) when compared to the non absorbable group (6.67%). An earlier return to work was seen in the patients with composite mesh.
Use of composite mesh in TAPP is associated with better patient outcomes in terms of less postoperative pain and an earlier return to work.
在当今时代,腹腔镜疝修补术很流行。手术医生和患者都关注术后腹股沟疼痛,现在它已取代复发成为影响生活质量的主要因素。
我们的研究旨在比较标准不可吸收聚丙烯网片和新型部分可吸收复合网片的早期术后结果。
本研究共纳入60例单侧单纯性腹股沟疝患者,随机分为两组,每组使用一种网片。患者在签署书面知情同意书后接受经腹腹膜前(TAPP)疝修补术。在术后即刻和三个月时进行随访。比较患者的腹股沟疼痛、沉重感、血清肿/血肿形成情况以及恢复工作活动的情况。应用标准统计检验,p值<0.05被视为具有显著性。
与使用不可吸收网片的患者相比,复合网片组患者在三个月时抱怨疼痛明显减轻(p值0.003)。他们还报告腹股沟区域的沉重感较轻。然而,复合网片组血清肿形成的发生率(20%)高于不可吸收网片组(6.67%)。使用复合网片的患者恢复工作更早。
在TAPP中使用复合网片与更好的患者结果相关,表现为术后疼痛减轻和恢复工作更早。