Comparison of extended view totally extraperitoneal with intraperitoneal onlay mesh for primary ventral hernia surgery: A randomised controlled study from a tertiary university hospital.

IF 1.1 4区 医学 Q3 SURGERY
Pawanindra Lal, Jony Kumar, Tusharindra Lal, Anubhav Vindal
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引用次数: 0

Abstract

Introduction: Primary ventral hernia remains a common presentation in surgical clinics with reported recurrence rates of 10%-20%. Intraperitoneal onlay mesh (IPOM) repair has been the widely accepted technique for laparoscopic management of ventral hernia. More recently, extended view totally extraperitoneal (eTEP) repair has emerged as a safe procedure in terms of reduced post-operative pain and faster recovery. Studies comparing IPOM with eTEP are limited. The present study was conducted to compare the two surgical techniques in terms of early outcomes in patients presenting with primary ventral hernia.

Patients and methods: A total of 30 patients with primary ventral hernias with defect size > 2 and up to 6 cm were randomised using computer-generated sequences into two groups. Operative time was used as the primary endpoint. Patients were followed up at 6 months, 1 year and 2 years postoperatively to look for recurrence, chronic pain and any other complications.

Results: Mean operative time in the IPOM group was significantly less than eTEP repair (P < 0.001). Mean pain scores in the eTEP group at discharge, on day 1 and 1 week were significantly lower than corresponding scores in the IPOM group. The mean hospital stay (2.09 ± 0.30 days) in the eTEP group was less than the IPOM group (3.64 ± 1.56 days) (P < 0.001). Return to work was also significantly earlier in eTEP (10.18 ± 1.07 days vs. 13.55 ± 2.16 [P < 0.001]). No recurrence was recorded in 23 of 30 patients followed up till 2 years.

Conclusions: Operative time was significantly longer in the eTEP group, reaffirming the published data. Post-operative pain was significantly lower in patients undergoing the eTEP procedure up to 1 week. Consequently, hospital stay was also reduced and return to work was faster in these patients. Both procedures fared equally in terms of no recurrence with a 77% follow-up at 24 months.

原发性腹疝手术中全腹膜外扩视点与腹腔内补片的比较:一项来自某三级大学医院的随机对照研究。
简介:原发性腹疝仍然是外科诊所常见的表现,据报道复发率为10%-20%。腹膜内补片(IPOM)修补术是腹腔镜下腹疝治疗中被广泛接受的技术。最近,就减少术后疼痛和更快恢复而言,全腹膜外延伸视野(eTEP)修复已成为一种安全的手术。比较IPOM和eTEP的研究有限。本研究旨在比较两种手术方法对原发性腹疝患者早期预后的影响。患者和方法:使用计算机生成的序列将30例缺陷大小为bbbb2至6cm的原发性腹疝患者随机分为两组。手术时间作为主要终点。分别于术后6个月、1年和2年随访患者,观察复发、慢性疼痛及其他并发症。结果:IPOM组的平均手术时间明显少于eTEP修复组(P < 0.001)。eTEP组在出院时、第1天、第1周的平均疼痛评分均显著低于IPOM组。eTEP组平均住院时间(2.09±0.30 d)少于IPOM组(3.64±1.56 d) (P < 0.001)。eTEP患者恢复工作时间也明显提前(10.18±1.07天vs. 13.55±2.16天[P < 0.001])。30例患者随访2年,23例无复发。结论:eTEP组手术时间明显延长,与已发表的数据一致。接受eTEP手术1周的患者术后疼痛明显降低。因此,这些病人的住院时间也减少了,恢复工作的速度也更快了。在24个月的随访中,两种手术均无复发,随访率为77%。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.70
自引率
0.00%
发文量
151
审稿时长
36 weeks
期刊介绍: Journal of Minimal Access Surgery (JMAS), the official publication of Indian Association of Gastrointestinal Endo Surgeons, launched in early 2005. The JMAS, a quarterly publication, is the first English-language journal from India, as also from this part of the world, dedicated to Minimal Access Surgery. The JMAS boasts an outstanding editorial board comprising of Indian and international experts in the field.
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