Sankar Thaanesh, Ahmad Samir, C Srinivasan, Ananthasayanam Jasvant Ram
Department of Surgery, Sree Balaji Medical College and Hospital, Chennai, IND.
Department of Radiodiagnosis, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Aug 14;16(8):e66896. doi: 10.7759/cureus.66896. eCollection 2024 Aug.
Background Inguinal hernia repair is a common surgical procedure addressing the protrusion of abdominal viscera through the inguinal canal. Despite advancements, complications such as chronic postoperative pain, infections, and hernia recurrence persist. Traditional sutured polypropylene mesh can cause nerve irritation and inflammation, leading to chronic pain and other issues. Innovations in hernia repair, like the self-gripping, low-density, macroporous polyester mesh, aim to mitigate these problems. This mesh adheres to tissues without sutures, potentially reducing operative time, postoperative pain, and related complications. The study compares the clinical outcomes of sutureless self-gripping polyester mesh versus sutured polypropylene mesh in inguinal hernia repair, focusing on operative time, postoperative pain, hospital stay length, seroma formation, and hernia recurrence to evaluate the effectiveness and safety of the self-gripping mesh. Methodology This cross-sectional study was conducted over one year at our hospital. Sixty patients with uncomplicated primary inguinal hernias were enrolled and divided into two groups: group A (self-gripping polyester mesh) and group B (sutured polypropylene mesh). The primary outcomes measured included operative time, postoperative pain (visual analog scale), hospital stay length, seroma formation, and hernia recurrence. Statistical analysis was performed using SPSS version 21.0 (IBM Corp., Armonk, NY), with descriptive and inferential statistics applied to compare the outcomes between the groups. Results The study found no significant differences in demographic variables between the two groups. The self-gripping polyester mesh (SF) group had significantly shorter operative times (67.2 minutes vs. 88.1 minutes, p < 0.001), lower postoperative pain scores (3.30 vs. 4.60, p < 0.001), and shorter hospital stays (3.2 days vs. 5.2 days, p = 0.000) compared to the sutured polypropylene mesh (SM) group. Rates of seroma formation and hernia recurrence were not significantly different between the groups. Multivariate regression analysis indicated that the type of mesh was a significant predictor of postoperative pain scores, with self-gripping mesh associated with lower pain. Conclusions Self-gripping polyester mesh offers significant advantages over traditional sutured polypropylene mesh in inguinal hernia repair, including reduced operative time, postoperative pain, and hospital stay without increasing the risk of seroma formation or hernia recurrence. These findings suggest that self-gripping mesh may be a superior option for inguinal hernia repair, potentially improving patient outcomes and reducing healthcare costs. Further multicenter studies with longer follow-up periods are recommended to confirm these benefits.
腹股沟疝修补术是一种常见的外科手术,用于解决腹腔脏器通过腹股沟管突出的问题。尽管取得了进展,但诸如慢性术后疼痛、感染和疝复发等并发症仍然存在。传统的缝合聚丙烯网片可引起神经刺激和炎症,导致慢性疼痛和其他问题。疝修补术的创新,如自固定、低密度、大孔聚酯网片,旨在减轻这些问题。这种网片无需缝合即可粘附于组织,有可能减少手术时间、术后疼痛及相关并发症。本研究比较了无缝合自固定聚酯网片与缝合聚丙烯网片在腹股沟疝修补术中的临床效果,重点关注手术时间、术后疼痛、住院时间、血清肿形成和疝复发情况,以评估自固定网片的有效性和安全性。
本横断面研究在我院进行了一年。纳入60例无并发症的原发性腹股沟疝患者,分为两组:A组(自固定聚酯网片)和B组(缝合聚丙烯网片)。测量的主要结局包括手术时间、术后疼痛(视觉模拟评分)、住院时间、血清肿形成和疝复发。使用SPSS 21.0版(IBM公司,纽约州阿蒙克)进行统计分析,应用描述性和推断性统计比较两组的结局。
研究发现两组患者的人口统计学变量无显著差异。与缝合聚丙烯网片(SM)组相比,自固定聚酯网片(SF)组的手术时间显著缩短(67.2分钟对88.1分钟,p<0.001),术后疼痛评分更低(3.30对4.60,p<0.001),住院时间更短(3.2天对5.2天,p = 0.000)。两组血清肿形成和疝复发率无显著差异。多因素回归分析表明,网片类型是术后疼痛评分的重要预测因素,自固定网片与较低的疼痛相关。
在腹股沟疝修补术中,自固定聚酯网片比传统的缝合聚丙烯网片具有显著优势,包括减少手术时间、术后疼痛和住院时间,且不增加血清肿形成或疝复发的风险。这些发现表明,自固定网片可能是腹股沟疝修补术的更好选择,有可能改善患者预后并降低医疗成本。建议进行更长随访期的进一步多中心研究以证实这些益处。