Jain Sudhir Kumar, Bhatia Sushant, Hameed Tariq, Khan Rehan, Dua Amrita
Director-Professor, Department of General Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
MCh. Resident, Department of GI Surgery & Liver Transplant, All India Institute of Medical Sciences, New Delhi, India.
Ann Med Surg (Lond). 2021 Jun 12;67:102486. doi: 10.1016/j.amsu.2021.102486. eCollection 2021 Jul.
Ever since the advent of mesh hernioplasty with low recurrence rates, surgeons have turned a blind eye towards its devastating mesh related complications. Consequently, the quest for the best hernia surgery, that is as effective as the mesh repair but lacks its complications, continues.
The present study was carried out to compare the results of the Lichtenstein repair with the Desarda repair in the treatment of inguinal hernias.
A total of 77 patients with 87 hernias were randomly allocated into two groups to undergo either the Desarda repair (Group I, 39 patients with 45 hernias) or the Lichtenstein repair (Group II, Control, 38 patients with 42 hernias). 3 patients didn't complete the follow-up and were excluded from analysis. Finally, 40 hernias were analyzed in the Lichtenstein group and 44 in the Desarda group.
After a 6-month follow-up period it was found that neither of the two groups had any recurrence. The incidence of chronic inguinodynia was much higher in the Lichtenstein group as compared to Desarda group. The pain scores, mean operating time, mean time to return to work and analgesic requirement was much lower with the Desarda repair as compared to Lichtenstein repair.
Desarda repair was found to be as effective as the Lichtenstein repair in terms of recurrence and better in terms of chronic inguinodynia, complications and post operative pain scores. Desarda repair requires a significantly shorter operating time. The economic burden of this repair is much less compared to mesh repair.
自从出现复发率低的疝修补网片成形术以来,外科医生一直对其与网片相关的毁灭性并发症视而不见。因此,人们仍在继续探寻最佳的疝修补手术,这种手术要像网片修补一样有效,但没有其并发症。
本研究旨在比较李金斯坦修补术和德萨尔达修补术治疗腹股沟疝的效果。
总共77例患有87个疝的患者被随机分为两组,分别接受德萨尔达修补术(第一组,39例患者有45个疝)或李金斯坦修补术(第二组,对照组,38例患者有42个疝)。3例患者未完成随访,被排除在分析之外。最后,李金斯坦组分析了40个疝,德萨尔达组分析了44个疝。
经过6个月的随访期发现,两组均无复发。与德萨尔达组相比,李金斯坦组慢性腹股沟疼痛的发生率要高得多。与李金斯坦修补术相比,德萨尔达修补术的疼痛评分、平均手术时间、平均恢复工作时间和镇痛需求要低得多。
发现德萨尔达修补术在复发方面与李金斯坦修补术一样有效,在慢性腹股沟疼痛、并发症和术后疼痛评分方面更好。德萨尔达修补术所需的手术时间明显更短。与网片修补相比,这种修补术的经济负担要小得多。