Konstantinos Zarras, Jens Plambeck, Joseph Kankam, Martin Hukauf, Ferdinand Köckerling
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引用次数: 0
摘要
简介：由于缺乏证据，狭缝网在腹腔镜内镜疝修补中的使用是一个有争议的话题。因此，这一关键问题需要进一步研究。方法：回顾性分析Herniamed Registry中前瞻性记录的数据，比较腹腔镜内镜下切口补片与非切口补片修补腹股沟疝围手术期和1年随访结果。对1028对进行了配对。结果：1年随访时，狭缝补片的复发率有显著差异(0.6% vs 1.8%；p = 0.023)。其他结果变量（术中并发症、一般并发症、术后并发症、并发症相关的再手术、休息时疼痛、用力时疼痛和1年随访时需要治疗的疼痛）均未发现此类系统性差异。结论：在腹腔镜内镜下腹股沟疝修补术中，狭缝补片与非狭缝补片的复发率明显较低。与任何其他结果标准没有关系。由于在腹腔镜-内窥镜腹股沟疝修补中使用狭缝补片似乎会影响结果，因此该主题应进一步研究。
Do we have to rethink slit-mesh technique in endoscopic inguinal hernia repair? - A matched pair analysis.
Introduction: Due to a lack of evidence, the use of slit meshes in laparo-endoscopic hernia repair is a topic of controversial debate. Therefore, further studies are needed on this key question.
Methods: This retrospective analysis of prospectively recorded data from the Herniamed Registry compared the perioperative and 1-year follow-up outcomes after laparo-endoscopic inguinal hernia repair with slit mesh versus non-slit mesh. Matching was performed for 1,028 pairs.
Results: A significant difference was identified in the recurrence rate on 1-year follow-up in favor of the slit mesh (0.6% vs 1.8%; p = 0.023). No such systematic difference was found for any of the other outcome variables (intraoperative complications, general complications, postoperative complications, complication-related reoperations, pain at rest, pain on exertion, and pain requiring treatment on 1-year follow-up).
Conclusion: The use of a slit mesh versus a non-slit mesh in laparo-endoscopic inguinal hernia repair is associated with a significantly lower recurrence rate. There is no relation with any other outcome criteria. Since the use of a slit mesh in laparo-endoscopic inguinal hernia repair seems to influence the outcome, this topic should be further investigated.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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