Suárez-Grau Juan Manuel, Navarro-Morales Laura, Tallon-Aguilar Luis, Morales-Conde Salvador, Padillo-Ruiz Francisco Javier
Virgen del Rocío University Hospital, Seville, Spain.
Quirónsalud Sacred Heart Hospital, Seville, Spain.
J Abdom Wall Surg. 2024 May 1;3:12562. doi: 10.3389/jaws.2024.12562. eCollection 2024.
To describe and compare a peritoneal closure technique using cyanoacrylate glue (Glubran 2, GEM, Cardiolink SL) with a microdroplet device (Glutack, GEM, Cardiolink SL) in laparoscopic transabdominal preperitoneal repair (TAPP) of inguinal hernia with the routinely used barbed suture peritoneal closure (V-Lock 3.0, Covidien France).
From January to August 2022, 60 patients undergoing TAPP repair for uni- or bilateral inguinal hernia were randomized into one of two groups. One using as mesh fixation and peritoneal closure the Glutack device with Glubran 2 cyanoacrylate glue (Glu-close group) and the other using mesh fixation with cyanoacrylate and peritoneal closure with V-lock 3.0 (Sut-close group), with a follow-up of 12 months. Demographic variables, operative time, peritoneal closure time, main surgical findings and main intra- and postoperative complications were analyzed prospectively.
63 patients were included with no losses to follow-up. The mean operative time was 34 min (range 58.25) for the glu-close group and 40 (range 64.25) for the sut-close group, with no conversion (0%) for either group. The mean flap closure time was 1.18 min (SD 24 0.19) for the glu-close group and 3.24 min (SD 0.78) for the sut-close group, with statistically significant differences ( < 0.001). The intraoperative complication rate was 0 for the glu-close group and 0 for the sut-close group, with no significant difference. The median hospital stay was 0.8 days (range, 0-1) for both groups. The median duration of follow-up was 12 months and none had hernia recurrence. The postoperative VAS score at the first and second check-up at 1 month and 3 months was 2.83 (SD 1.341) and 0.60 (SD 0.621) in the sut-close group and 1.03 (0.984) and 0.24 (SD 0.435) in the glue-close group, with significant differences ( < 0.001 and < 0.012).
The data demonstrated by the study are that the glue can be used safely to close the peritoneum and that the method provides a small, statistically significant but not clinically relevant reduction in the time to close the peritoneal flap, as well as in postoperative pain after surgery in short and medium term.
描述并比较在腹腔镜经腹腹膜前修补术（TAPP）治疗腹股沟疝中，使用氰基丙烯酸酯胶水（Glubran 2，GEM，Cardiolink SL）搭配微滴装置（Glutack，GEM，Cardiolink SL）进行腹膜关闭的技术，与常规使用的倒刺缝线腹膜关闭（V-Lock 3.0，Covidien France）。
2022年1月至8月，60例接受单侧或双侧腹股沟疝TAPP修补术的患者被随机分为两组。一组使用Glutack装置搭配Glubran 2氰基丙烯酸酯胶水进行补片固定和腹膜关闭（胶水关闭组），另一组使用氰基丙烯酸酯进行补片固定，并用V-lock 3.0进行腹膜关闭（缝线关闭组），随访12个月。前瞻性分析人口统计学变量、手术时间、腹膜关闭时间、主要手术发现以及主要的术中和术后并发症。
纳入63例患者，无失访。胶水关闭组的平均手术时间为34分钟（范围58.25），缝线关闭组为40分钟（范围64.25），两组均无中转（0%）。胶水关闭组的平均皮瓣关闭时间为1.18分钟（标准差24 0.19），缝线关闭组为3.24分钟（标准差0.78），差异有统计学意义（<0.001）。胶水关闭组和缝线关闭组的术中并发症发生率均为0，无显著差异。两组的中位住院时间均为0.8天（范围0 - 1）。中位随访时间为12个月，均无疝复发。缝线关闭组在术后1个月和3个月的首次和第二次检查时的VAS评分分别为2.83（标准差1.341）和0.60（标准差0.621），胶水关闭组分别为1.03（0.984）和0.24（标准差0.435），差异有统计学意义（<0.001和<0.012）。
该研究的数据表明，胶水可安全用于关闭腹膜，该方法在关闭腹膜皮瓣的时间以及短期和中期术后疼痛方面有微小的、统计学上有显著意义但临床上无显著相关性的减少。
