Department of General Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Surgery, Jam General Hospital, Tehran, Iran.
Am J Surg. 2021 Jul;222(1):203-207. doi: 10.1016/j.amjsurg.2020.10.029. Epub 2020 Nov 6.
Inguinal hernia is a common surgical problem and different methods are currently used to repair it. In The Lichtenstein technique, the inguinal floor defect is buttressed with a prosthetic mesh and commonly, sutures are used for mesh fixation. N-Hexyl Cyanoacrylate is a gluelike product that can be used for mesh fixation as a substitute with fewer complications. This study was done for comparing therapeutic outcomes of mesh fixation with suture and N-Hexyl cyanoacrylate glue in inguinal hernia repair with the Lichtenstein method.
In a two-arm parallel-group randomised controlled trial with blinded patients, 58 hernia cases who were candidates for hernia repair with the Lichtenstein method entered the study and randomly divided into two groups. In the control group, the mesh that was used for inguinal floor reinforcement was fixed with sutures and in the intervention group with N-Hexyl Cyanoacrylate glue. The results including acute and chronic pain, hospital stay, complications, and recurrence rate after one year were compared.
There was no recurrence. According to the numeric rating scale (NRS), mean postoperative pain (acute pain) was 6.5 and 5.7 points in the suture and N-Hexyl Cyanoacrylate glue groups respectively, with significant difference (P = 0.006). Mean duration of surgery was 73.3 and 64.5 min in the suture and N-Hexyl cyanoacrylate glue groups respectively, with significant difference (P = 0.014). Complications, hospital stay days, and chronic pain did not differ across the groups (P > 0.05).
Mesh fixation with N-Hexyl cyanoacrylate glue in hernia repair with the Lichtenstein method can lower postoperative pain and duration of surgery and this product might be used as a substitute for suture.
腹股沟疝是一种常见的外科问题，目前有多种方法可用于修复。在李斯蒂恩术式中，使用补片对腹股沟底部缺损进行加强，通常使用缝线进行补片固定。N-己基氰基丙烯酸酯是一种胶状产品，可作为缝线固定的替代品，且并发症更少。本研究旨在比较李斯蒂恩术式中使用缝线和 N-己基氰基丙烯酸酯胶固定补片治疗腹股沟疝的疗效。
采用双盲患者的双臂平行随机对照试验，58 例符合李斯蒂恩术式疝修补术适应证的患者入组，并随机分为两组。在对照组中，用于加强腹股沟底部的补片用缝线固定，在干预组中用 N-己基氰基丙烯酸酯胶固定。比较两组患者的术后即刻及 1 年随访时的急性和慢性疼痛、住院时间、并发症和复发率等结果。
无复发。根据数字评分量表（NRS），缝线组和 N-己基氰基丙烯酸酯胶组的术后平均疼痛（急性疼痛）分别为 6.5 分和 5.7 分，差异有统计学意义（P=0.006）。缝线组和 N-己基氰基丙烯酸酯胶组的手术平均时间分别为 73.3 分钟和 64.5 分钟，差异有统计学意义（P=0.014）。两组患者的并发症、住院天数和慢性疼痛无差异（P>0.05）。
李斯蒂恩术式中使用 N-己基氰基丙烯酸酯胶固定补片可降低术后疼痛和手术时间，该产品可作为缝线的替代品。
