General Surgery Department, Siedlce Hospital, ul. Narutowicza 25, 08-110, Siedlce, Poland.
Department of Health Sciences, University of Natural Sciences and Humanities, Siedlce, Poland.
Hernia. 2019 Jun;23(3):547-554. doi: 10.1007/s10029-019-01879-y. Epub 2019 Jan 18.
The aim of the study was to offer a prospective comparative assessment of long-term outcomes for inguinal hernia repair using Valenti and Lichtenstein techniques.
568 surgical procedures for unilateral inguinal hernia repair using the Valenti (group V) or the Lichtenstein technique (group L) were performed. After the mean follow-up time of 9 years (8-12), 185 patients (70.1%) treated using Valenti method and 186 patients (71.3%) treated using Lichtenstein method were clinically assessed. All clinical data were registered in National Hernia Registry. The rate of recurrence was assessed as primary outcome. The secondary outcome involved chronic pain (VAS).
9-year recurrence rate was 2.2% in both groups. No significant difference in recurrence rate was demonstrated in analysis adjusted for surgeon's education, type of hernia, hernia size, hernia duration, or BMI between two groups (OR 1.0; 95% CI 0.69-1.67; p = 1.0). In follow-up the majority of patients reported no pain (71.9% in V; 73.7% in L). A constant pain was reported by four patients in each group. Severe pain was reported by 1.6% in V and 2.1% in L (p = 0.192).
Inguinal hernia repairs using Valenti and Lichtenstein methods show high, long-term effectiveness and do not significantly differ in the recurrence rate. Both methods ensure a low rate of chronic pain. The use of a single mesh size with a precisely defined shape and of a uniform mesh fixation method ensures the standardization of surgical technique. The Valenti method is an uncomplicated, technically reproducible procedure with a low learning curve.
本研究旨在对使用 Valenti 和 Lichtenstein 技术治疗腹股沟疝修补术的长期结果进行前瞻性比较评估。
对 568 例单侧腹股沟疝修补术（使用 Valenti 组[V 组]或 Lichtenstein 组[L 组]）进行回顾性分析。在平均 9 年（8-12 年）的随访后，对 185 例接受 Valenti 方法治疗的患者（70.1%）和 186 例接受 Lichtenstein 方法治疗的患者（71.3%）进行了临床评估。所有临床数据均登记在国家疝登记处。复发率作为主要结局进行评估。次要结局包括慢性疼痛（VAS）。
两组 9 年复发率均为 2.2%。调整外科医生教育程度、疝类型、疝大小、疝持续时间或 BMI 后，两组之间的复发率无显著差异（OR 1.0；95%CI 0.69-1.67；p=1.0）。在随访中，大多数患者报告无疼痛（V 组 71.9%，L 组 73.7%）。两组各有 4 例患者报告持续性疼痛。V 组有 1.6%的患者报告严重疼痛，L 组有 2.1%的患者报告严重疼痛（p=0.192）。
使用 Valenti 和 Lichtenstein 方法治疗腹股沟疝具有较高的长期疗效，复发率无显著差异。两种方法均可确保慢性疼痛发生率较低。使用具有精确形状和统一网片固定方法的单一网片尺寸可确保手术技术的标准化。Valenti 方法是一种操作简单、技术可重复、学习曲线低的手术。
