Cabrera-Vargas Luis F, Mendoza-Zuchini Andrés, Aparicio Brandon S, Pedraza Mauricio, Sajona-Leguia Walter A, Arias Jhoan S R, Lozada-Martinez Ivan D, Picón-Jaimes Yelson A, Narvaez-Rojas Alexis R
Department of Surgery Universidad El Bosque Bogotá Colombia.
School of Medicine Universidad El Bosque Bogotá Colombia.
Health Sci Rep. 2023 Mar 16;6(3):e1151. doi: 10.1002/hsr2.1151. eCollection 2023 Mar.
Inguinal hernia is the most common defect of the abdominal wall in 75% and their treatment consists of surgical repair. The technique of choice is laparoscopic because of its overall benefits. However, when this is not available, open approaches may be a viable option. Currently, the most commonly used open techniques are Lichtenstein and Nyhus. However, there are few medium- or long-term studies that have compared outcomes between these two techniques.
This is a retrospective comparative study that included patients undergoing open inguinal hernia correction with mesh, using Lichtenstein open hernioplasty versus Nyhus preperitoneal hernioplasty, in two tertiary referral centers in Bogota, Colombia, during a period of 2 years. A bivariate analysis was performed to compare groups, according to the complications presented between the two techniques.
A total of 193 patients were included, of whom 53.36% were men and 112 (58.03%) were approached with the Nyhus technique versus 81 patients with the Lichtenstein technique. Nonabsorbable suture fixation was performed in 100% of patients. Among the main complications, seroma (5.18%), pain (4.14%), bleeding (2.07%), recurrence (10.88%), and reoperation (0.51%) were observed, of which only recurrence showed a statistically significant difference, which is lower in the Nyhus approach (3.57% vs. 20.67%; < 0.001). No patients died.
Both Nyhus and Lichtenstein hernioplasty techniques were shown to cause a low incidence of postoperative complications, with significantly lower recurrence using the Nyhus technique up to 1 year postoperatively.
腹股沟疝是最常见的腹壁缺损,占比75%,其治疗方法为手术修复。由于其整体优势,首选的技术是腹腔镜手术。然而,当无法进行腹腔镜手术时,开放手术可能是一个可行的选择。目前,最常用的开放技术是利chtenstein术式和Nyhus术式。然而,很少有中长期研究比较这两种技术的疗效。
这是一项回顾性比较研究,纳入了在哥伦比亚波哥大的两家三级转诊中心接受开放腹股沟疝修补术并使用补片的患者,采用利chtenstein开放式疝修补术与Nyhus腹膜前疝修补术,为期2年。根据两种技术出现的并发症进行双变量分析以比较组间差异。
共纳入193例患者,其中53.36%为男性,112例(58.03%)采用Nyhus技术,81例采用利chtenstein技术。所有患者均采用不可吸收缝线固定。在主要并发症中,观察到血清肿(5.18%)、疼痛(4.14%)、出血(2.07%)、复发(10.88%)和再次手术(0.51%),其中只有复发显示出统计学显著差异,Nyhus手术方式的复发率较低(3.57%对20.67%;<0.001)。无患者死亡。
Nyhus和利chtenstein疝修补术均显示术后并发症发生率较低,Nyhus技术术后1年内的复发率显著降低。