Mills I W, McDermott I M, Ratliff D A
Department of Surgery, Northampton General Hospital NHS Trust, Cliftonville, UK.
Br J Surg. 1998 Jun;85(6):790-2. doi: 10.1046/j.1365-2168.1998.00649.x.
The Lichtenstein tension-free repair has become the standard method for repairing inguinal hernia in many surgical units. This study compared two methods of mesh fixation.
Fifty men undergoing unilateral primary Lichtenstein inguinal hernia repair under general anaesthesia were randomized into two groups. In the control group polypropylene mesh was secured with 2/0 polypropylene sutures and the skin closed with subcuticular 3/0 polydioxanone. In the study group polypropylene mesh was secured with skin staples and the skin was closed with staples from the same staple gun. Duration of the operation was recorded. Early follow-up was achieved by patient review at 6 weeks and postal questionnaire at 12 weeks.
The operation was significantly shorter when staples were used (median 20 min 0 s versus 29 min 30 s, P < 0.001). There was no significant difference in the incidence of postoperative complications or pain score. The study group reported earlier return to normal activity (4 weeks 0 days versus 6 weeks 2 days, P < 0.01) although there was no difference in the time taken to return to work or driving.
The use of skin staples to secure mesh in the Lichtenstein inguinal hernia repair significantly reduced the duration of the operation and was as effective as conventional mesh fixation with polypropylene in the short term.
在许多外科科室，利希滕斯坦无张力修补术已成为腹股沟疝修补的标准方法。本研究比较了两种补片固定方法。
50例接受全身麻醉下单侧原发性利希滕斯坦腹股沟疝修补术的男性患者被随机分为两组。对照组用2-0聚丙烯缝线固定聚丙烯补片，用3-0聚二氧六环酮皮下缝合关闭皮肤。研究组用皮肤吻合器固定聚丙烯补片，并用同一吻合器的吻合钉关闭皮肤。记录手术时间。通过术后6周的患者复查和12周的邮寄问卷调查进行早期随访。
使用吻合器时手术时间明显缩短（中位数20分0秒对29分30秒，P<0.001）。术后并发症发生率和疼痛评分无显著差异。研究组报告恢复正常活动的时间更早（4周0天对6周2天，P<0.01），尽管恢复工作或开车所需的时间没有差异。
在利希滕斯坦腹股沟疝修补术中使用皮肤吻合器固定补片可显著缩短手术时间，短期内与传统的聚丙烯补片固定效果相同。
