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利氏手术与腹腔镜手术治疗单侧原发性腹股沟疝术后疼痛的对比研究

COMPARATIVE STUDY OF POSTOPERATIVE PAIN BETWEEN THE LICHTENSTEIN AND LAPAROSCOPY SURGICAL TECHNIQUES FOR THE TREATMENT OF UNILATERAL PRIMARY INGUINAL HERNIA.

作者信息

Pedroso Leandro Mendonça, DE-Melo Renato Miranda, DA-Silva Nelson Jorge

机构信息

Medical, Pharmaceutical and Biomedical Sciences School, Pontifical Catholic University of Goiás (PUC-GO), Goiânia, Goiás, Brazil.

出版信息

Arq Bras Cir Dig. 2017 Jul-Sep;30(3):173-176. doi: 10.1590/0102-6720201700030003.

DOI:10.1590/0102-6720201700030003
PMID:29019556
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5630208/
Abstract

BACKGROUND

There are several surgical treatment options for inguinal hernia; however, there is no consensus on the literature identifying which surgical technique promotes less postoperative pain.

AIM

To compare the intensity of postoperative pain between the surgical techniques Lichtenstein and transabdominal pre-peritoneal laparoscopy for the treatment of unilateral primary inguinal hernia.

METHODS

Were included 60 patients, of which 30 were operated through the Lichtenstein technique and 30 patients through the transabdominal pre-peritoneal laparoscopy. The pain levels were evaluated through the analogue visual scale for 2, 10 and 30 days after the surgery. Additionally, the recurrence rate and the presence of chronic pain and paresthesia were evaluated 12 months after the surgery.

RESULTS

Overall, the data analysis showed significant differences on pain levels between the surgical techniques. There were no significant differences between the pain levels for day 2. However, for 10 and 30 days after the surgery, the pain levels were significantly lower for the patients operated through the transabdominal pre-peritoneal laparoscopy technique compared to the Lichtenstein technique. Furthermore, despite no recurrent hernias for both surgical techniques, 32 % of patients operated through the Lichtenstein technique reported chronic pain and paresthesia 12 months after the surgery, compared with 3,6% of patients operated through the transabdominal pre-peritoneal laparoscopy technique.

CONCLUSION

There are differences between the surgical techniques, with the transabdominal pre-peritoneal laparoscopy procedure promoting significantly lower postoperative pain (10 and 30 days) and chronic pain (12 months) compared to the Lichtenstein procedure.

摘要

背景

腹股沟疝有多种手术治疗选择;然而,关于哪种手术技术能减轻术后疼痛,文献中尚无共识。

目的

比较利氏手术和经腹腹膜前腹腔镜手术治疗单侧原发性腹股沟疝术后疼痛的强度。

方法

纳入60例患者,其中30例采用利氏手术,30例采用经腹腹膜前腹腔镜手术。术后2天、10天和30天通过视觉模拟评分法评估疼痛程度。此外,术后12个月评估复发率、慢性疼痛和感觉异常的情况。

结果

总体而言,数据分析显示手术技术之间在疼痛程度上存在显著差异。术后第2天的疼痛程度无显著差异。然而,术后10天和30天,经腹腹膜前腹腔镜手术患者的疼痛程度明显低于利氏手术患者。此外,尽管两种手术技术均无复发性疝,但利氏手术患者中有32%在术后12个月报告有慢性疼痛和感觉异常,而经腹腹膜前腹腔镜手术患者的这一比例为3.6%。

结论

手术技术之间存在差异,与利氏手术相比,经腹腹膜前腹腔镜手术术后疼痛(10天和30天)和慢性疼痛(12个月)明显更低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2201/5630208/8fb77a62b94d/0102-6720-abcd-30-03-00173-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2201/5630208/8fb77a62b94d/0102-6720-abcd-30-03-00173-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2201/5630208/8fb77a62b94d/0102-6720-abcd-30-03-00173-gf1.jpg

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