Ali Iqbal, Dikshit Vashisht, Manerikar Kshitij, Dholakia Mirat, Save Maitreyee
Department of Surgery, Dr. D. Y. Patil Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune.
Surg J (N Y). 2018 May 23;4(2):e82-e86. doi: 10.1055/s-0038-1653980. eCollection 2018 Apr.
The open preperitoneal repair offers the benefits of placing the mesh in the preferred position while avoiding the disadvantages of laparoscopic repair. A total of 60 patients with bilateral inguinal hernias were randomized to undergo either the standard Lichtenstein meshplasty or the modified iliopubic tract repair in a teaching hospital. Outcomes measured were immediate postoperative pain, return to activity, and delayed neurological complications. Patients who underwent the iliopubic tract repair walked out of bed faster than the Lichtenstein group (6.3 hours vs 7.4 hours, < 0.0001) and experienced significant lower pain as charted by visual analogue scale scores (3.28 vs 2.71 on day 1, 2.16 vs 1.71 on day 2, 1.92 vs 1.08 on day 3; < 0.05). Delayed complications like chronic inguinal pain and numbness were not seen in the iliopubic tract group. However, this difference was not statistically significant ( > 0.05). The iliopubic tract repair offers an excellent alternative to the Lichtenstein meshplasty, and is associated with lower postoperative pain, earlier return to work, and lower delayed neurological complications.
开放式腹膜前修补术具有将补片置于理想位置的优点，同时避免了腹腔镜修补术的缺点。在一家教学医院，共有60例双侧腹股沟疝患者被随机分为两组，分别接受标准的利氏疝修补术或改良髂耻束修补术。测量的结果指标包括术后即刻疼痛、恢复活动情况以及延迟性神经并发症。接受髂耻束修补术的患者比接受利氏疝修补术的患者下床更快（6.3小时对7.4小时，P＜0.0001），并且根据视觉模拟评分量表记录，疼痛明显减轻（第1天为3.28对2.71，第2天为2.16对1.71，第3天为1.92对1.08；P＜0.05）。髂耻束修补术组未出现慢性腹股沟疼痛和麻木等延迟性并发症。然而，这种差异无统计学意义（P＞0.05）。髂耻束修补术是利氏疝修补术的一种极佳替代方法，与术后疼痛减轻、更早恢复工作以及更低的延迟性神经并发症相关。
