Philipp Mark, Leuchter Matthias, Lorenz Ralph, Grambow Eberhard, Schafmayer Clemens, Wiessner Reiko
Department of General, Visceral, Thoracic, Vascular and Transplantation Surgery, Rostock University Medical Center, 18057 Rostock, Germany.
Institute for Implant Technology and Biomaterials-IIB E.V, Associated Institute of the University of Rostock, 18119 Warnemuende, Germany.
J Clin Med. 2023 Jan 28;12(3):1001. doi: 10.3390/jcm12031001.
Inguinal hernia repair, according to Desarda, is a pure tissue surgical technique using external oblique fascia to reinforce the posterior wall of the inguinal canal. This has provided an impetus for the rethinking of guideline adherence toward minimally invasive and mesh-based surgery of inguinal hernia. In this study, a retrospective analysis of this technique was conducted in two German hospitals. Between 6/2013 and 12/2020, 120 operations were performed. Analysis included patient characteristics, duration of operation, length of hospital stay, and perioperative complications. Data were used to achieve a matched-pair analysis comparing Desarda to laparoscopic transabdominal preperitoneal (TAPP) hernia repair. Propensity scores were calculated based on five preoperative variables, including sex, age, American Society of Anesthesiology classification, localization, and width of the inguinal hernia in order to achieve comparability. Additionally, we assessed pain level and quality of life (QoL) 12 months postoperatively. The focus of our study was a comparison of QoL to a reference population and TAPP cohort. The study population consisted of 106 male and 14 female patients, and the median age was 37.5 years. The median operation time was 50 min, and the median length of hospital stay was 2 days. At a follow-up of 17 months, the median recurrence rate was 0.8%, and two cases of chronic postoperative pain were recorded. Postoperative QoL does not significantly differ between Desarda and TAPP. In contrast, Desarda patients had a significantly higher QoL compared with the reference population. In summary, Desarda's procedure is a good option as a pure tissue method for inguinal hernia repair.
根据德萨尔达（Desarda）的方法，腹股沟疝修补术是一种单纯组织外科技术，利用腹外斜肌腱膜来加强腹股沟管后壁。这为重新思考腹股沟疝的微创手术和基于补片的手术的指南遵循情况提供了动力。在本研究中，对该技术在两家德国医院进行了回顾性分析。在2013年6月至2020年12月期间，共进行了120例手术。分析内容包括患者特征、手术时长、住院时间和围手术期并发症。数据用于进行配对分析，将德萨尔达手术与腹腔镜经腹腹膜前（TAPP）疝修补术进行比较。基于五个术前变量计算倾向得分，这些变量包括性别、年龄、美国麻醉医师协会分级、腹股沟疝的位置和宽度，以实现可比性。此外，我们评估了术后12个月的疼痛程度和生活质量（QoL）。我们研究的重点是将生活质量与参考人群和TAPP队列进行比较。研究人群包括106名男性和14名女性患者，中位年龄为37.5岁。中位手术时间为50分钟，中位住院时间为2天。在17个月的随访中，中位复发率为0.8%，记录到两例慢性术后疼痛病例。德萨尔达手术和TAPP手术术后的生活质量没有显著差异。相比之下，德萨尔达手术患者的生活质量与参考人群相比显著更高。总之，作为一种单纯组织方法，德萨尔达手术是腹股沟疝修补的一个好选择。
