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组织胶水与缝线用于开放无张力腹股沟疝修补术中补片固定的术后效果比较:一项前瞻性分析研究。

Comparison of postoperative outcomes between tissue glue and suture for mesh fixation in open tension-free inguinal hernia repair: a prospective analytical study.

作者信息

Regmi Nabin, Rajthala Lilamani, Subedi Rojina, Shrestha Eruka, Gurung Narendra Vikram

机构信息

Department of Surgery, Pokhara Academy of Health Sciences, Pokhara.

Department of Surgery, Patan Academy of Health Sciences, Patan, Nepal.

出版信息

Ann Med Surg (Lond). 2024 Aug 6;86(9):5039-5042. doi: 10.1097/MS9.0000000000002434. eCollection 2024 Sep.

Abstract

INTRODUCTION

A hernia is an abnormal protrusion of the viscus through the normal or abnormal opening of its containing cavity. Lichtenstein tension-free mesh repair is a commonly performed surgery for hernia. Various studies have revealed atraumatic fixation of the mesh produces less pain without compromising the outcomes.

METHODS

This is a prospective analytical study conducted in a tertiary hospital over a year. Eighty patients with primary inguinal hernia undergoing open mesh repair were enrolled and divided into two groups with 40 patients in each group. Mesh fixation was done with N-butyl 2 cyano-acrylate glue in one group, while polypropylene 2-0 suture in the other group. Postoperative pain, the number of dosages of analgesia required, the incidence of hematoma/seroma formation, surgical site infection, and length of hospital stay were compared between the two groups. Data were analyzed using SPSS 25.

RESULTS

Visual analog scores were significantly reduced in the glue group at 12 h and 24 h (<0.05) with a reduction of the mean number of analgesic doses from 6.42±0.984 in the suture group to 5.95±0.597 in the glue group (<0.05). The operating time was significantly reduced from 70.03±4.376 minutes in the suture group to 58.43±4.540 min in the glue group (<0.05), while there was no significant difference in the length of hospital stay. Five percent of cases in the suture group developed seroma while no SSI was reported in this study.

CONCLUSIONS

This study demonstrates mesh fixation with cyanoacrylate glue in open hernioplasty for primary groin hernias is associated with reduced immediate postoperative pain, dose of analgesia required, and operating time in comparison to fixation with suture.

摘要

引言

疝是指脏器通过其容纳腔的正常或异常开口发生的异常突出。利chtenstein无张力疝修补术是一种常见的疝手术。各种研究表明,网片的无创伤固定在不影响手术效果的情况下产生的疼痛较少。

方法

这是一项在一家三级医院进行的为期一年的前瞻性分析研究。80例接受开放式网片修补术的原发性腹股沟疝患者被纳入研究并分为两组,每组40例。一组用氰基丙烯酸正丁酯胶水进行网片固定,另一组用聚丙烯2-0缝线进行固定。比较两组患者术后疼痛情况、所需镇痛药物剂量、血肿/血清肿形成发生率、手术部位感染情况及住院时间。数据采用SPSS 25进行分析。

结果

胶水组在术后12小时和24小时的视觉模拟评分显著降低(<0.05),镇痛药物平均剂量从缝线组的6.42±0.984减少至胶水组的5.95±0.597(<0.05)。手术时间从缝线组的70.03±4.376分钟显著缩短至胶水组的58.43±4.540分钟(<0.05),而住院时间无显著差异。缝线组有5%的病例发生血清肿,本研究中未报告手术部位感染。

结论

本研究表明,与缝线固定相比,在原发性腹股沟疝开放修补术中使用氰基丙烯酸酯胶水进行网片固定可减少术后即刻疼痛、所需镇痛药物剂量及手术时间。

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