Sharma Pankaj Kumar, Khandelwal Manish, Pipal Dharmendra Kumar, Singh Yatindra, Kothari Saurabh, Verma Vijay, Yadav Seema, Singh Bhupendra, Jangid Gurusha
Department of General Surgery, Government Medical College, Kota, Rajasthan, India.
Department of General Surgery, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India.
J West Afr Coll Surg. 2023 Oct-Dec;13(4):67-72. doi: 10.4103/jwas.jwas_49_23. Epub 2023 Sep 16.
Hernioplasty, in which a mesh is used to strengthen a weakness or defect in the inguinal wall, has replaced simple tissue repair. As it is associated with low recurrence, it is considered the gold standard and is one of the most common general surgical procedures. The ideal repair should be rapid, safe and simple to do, requires minimal dissection to create sufficient space, be cost-effective and be accompanied by a brief hospital stay, reduced pain, and fewer recurrences. The aim of the present study was to compare the efficacy of 3-stitch mesh fixation with that of traditional Lichtenstein mesh fixation of inguinal hernia repair.
Between July 2018 and December 2019, 59 cases of primary, uncomplicated inguinal hernias were surgically treated. Both the classical Lichtenstein technique (group A, = 30) and the Lichtenstein technique with the three-stitch fixation method (group B, = 29) were used on patients with inguinal hernias. Between the two groups, the mean operative times, post-surgical pain scores, average hospital stays and postoperative complications including recurrence rates were compared.
With a -value of 0.001, the 3-point fixation group (group B) took 3.41 ± 0.58 min less time to fix the mesh than the Lichtenstein group (group A, 5.52 ± 0.59 min). The pain after surgery was much less for participants who had 3-point mesh fixation than for those who had conventional mesh fixation in the early (1, 3, 7 and 15 days after surgery) and late (1 month and 3 months) postoperative periods, with a -value of 0.0001. When compared to the classical mesh fixation group, the 3-point mesh fixation group had less urinary retention, seroma and swelling. Both groups had the same number of other complications.
The three-point hernioplasty is a simple procedure that is easier to adopt, less time-consuming, causes less trauma and has a lower risk of postoperative discomfort including chronic groin pain.
疝修补术采用补片加强腹股沟管壁的薄弱或缺损处，已取代了单纯的组织修复。由于其复发率低，被视为金标准，是最常见的普通外科手术之一。理想的修复应快速、安全且操作简单，所需的解剖操作最少以创造足够空间，具有成本效益，且住院时间短、疼痛减轻、复发率低。本研究的目的是比较三针法补片固定与传统的利氏疝修补术补片固定治疗腹股沟疝的疗效。
2018年7月至2019年12月期间，对59例原发性、非复杂性腹股沟疝患者进行了手术治疗。对腹股沟疝患者分别采用经典的利氏技术（A组，n = 30）和三针法固定的利氏技术（B组，n = 29）。比较两组患者的平均手术时间、术后疼痛评分、平均住院时间以及包括复发率在内的术后并发症。
P值为0.001，三点固定组（B组）补片固定时间比利氏组（A组，5.52 ± 0.59分钟）少3.41 ± 0.58分钟。在术后早期（术后1、3、7和15天）和晚期（1个月和3个月），三点补片固定的参与者术后疼痛明显轻于传统补片固定的参与者，P值为0.0001。与经典补片固定组相比，三点补片固定组的尿潴留、血清肿和肿胀更少。两组的其他并发症数量相同。
三点疝修补术是一种简单的手术，更容易采用，耗时更少，创伤更小，术后不适（包括慢性腹股沟疼痛）风险更低。
