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使用钛涂层补片行Lichtenstein修补术后的长期结局:一项回顾性队列研究。

Long-term outcomes after Lichtenstein repair using titanium-coated mesh: A retrospective cohort study.

作者信息

Akalin Cagri

机构信息

Cagri Akalin, Assistant Professor, Department of General Surgery, Ordu Medical School, Ordu, Turkey.

出版信息

Pak J Med Sci. 2021 Jan-Feb;37(1):81-86. doi: 10.12669/pjms.37.1.2694.

Abstract

OBJECTIVE

To examine the long-term outcomes such as recurrence, foreign body feeling and chronic pain of titanium-coated mesh (TCM) versus standard polypropylene mesh (PM) after Lichtenstein repair (LR).

METHODS

In this retrospective cohort study, patients who underwent TCM and PM in LR were evaluated between May 2014 and January 2018 at Ordu University Training and Research Hospital in Turkey. Primary outcomes (age, gender, body mass index, smoking habits, comorbid diseases, American Society of Anesthesiologists score, hernia type, side of hernia, duration of hernia presentation and operative time) and secondary outcomes (surgical site occurence, recurrence, foreign body feeling and chronic pain) were analyzed. Patients were divided into two groups according to the mesh elected (TCM and PM); titanium group (TG) and polypropylene group (PG), respectively.

RESULTS

In this study, 221 patients were analyzed; TCM was used in 72 (32.6%) patients and PM was used in 149 (67.4%) patients. No difference was found between groups in terms of primary outcomes (>0.05). In the analysis of secondary outcomes, surgical site occurence was similar in both groups (>0.05). Recurrence was observed in 1.39% (n=1) of TG and 2.01% (n=3) of PG. No difference was found between groups in terms of recurrence (=0.606). Foreign body feeling was observed in 15.3% (n=11) of TG and 27.5% (n=41) of PG. Chronic pain was observed in 4.2% (n=3) of TG and 12.8% (n=9) of PG. Significant differences were found between groups in terms of chronic pain and foreign body feeling (=0.046 and =0.044, respectively).

CONCLUSION

The result of this study shows that in LR, TCM leads to less foreign body feeling and chronic pain than PM. However, there was no difference in terms of recurrence between these meshes.

摘要

目的

比较在李金斯坦修补术(LR)后,钛涂层补片(TCM)与标准聚丙烯补片(PM)的长期预后,如复发、异物感和慢性疼痛。

方法

在这项回顾性队列研究中,于2014年5月至2018年1月期间,在土耳其奥尔杜大学培训与研究医院对接受LR并使用TCM和PM的患者进行评估。分析主要结局(年龄、性别、体重指数、吸烟习惯、合并疾病、美国麻醉医师协会评分、疝类型、疝的侧别、疝出现时间和手术时间)和次要结局(手术部位发生情况、复发、异物感和慢性疼痛)。根据所选补片将患者分为两组(TCM和PM);分别为钛组(TG)和聚丙烯组(PG)。

结果

本研究共分析了221例患者;72例(32.6%)患者使用了TCM,149例(67.4%)患者使用了PM。两组在主要结局方面无差异(>0.05)。在次要结局分析中,两组手术部位发生情况相似(>0.05)。TG组复发率为1.39%(n = 1),PG组为2.01%(n = 3)。两组在复发方面无差异(=0.606)。TG组有15.3%(n = 11)出现异物感,PG组为27.5%(n = 41)。TG组有4.2%(n = 3)出现慢性疼痛,PG组为12.8%(n = 9)。两组在慢性疼痛和异物感方面存在显著差异(分别为=0.046和=0.044)。

结论

本研究结果表明,在LR中,TCM比PM导致的异物感和慢性疼痛更少。然而,这些补片在复发方面无差异。

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