Fijación del material protésico en la hernioplastia inguinal abierta: sutura vs. cola sintética / Prosthetic material fixation in open inguinal hernioplasty: suture vs. synthetic glue

Introducción: El empleo de colas sintéticas se ha convertido en práctica habitual en varios campos quirúrgicos. El objetivo de este estudio es comparar los resultados del pegamento y de la sutura convencional a corto y a medio plazo en la fijación de las prótesis en la hernioplastia inguinal abierta con técnica de tapón y parche. Materiales y métodos Estudio prospectivo comparativo incluyendo 198 pacientes con diagnóstico de hernia inguinal no recidivada intervenidos a cielo abierto y asignados de manera aleatoria a fijación de las mallas con pegamento de cianoacrilato (n=101) o con sutura (n=98). Se analizaron las características demográficas, las complicaciones a corto plazo, la estancia postoperatoria, la baja laboral, la recidiva herniaria y la neuralgia inguinal crónica. Resultados La morbilidad global ha sido del 13,9% en el grupo del pegamento y del 30,9% en el grupo de sutura. No observamos reacciones inflamatorias ni casos de migración de la prótesis. La estancia postoperatoria ha sido de 14,7h en el caso de fijación con pegamento y de 19,1h en el caso de suturas (p<0,0001). No encontramos diferencia entre los 2 grupos en cuanto a días de baja laboral. La morbilidad a corto plazo fue superior en el caso de fijación con sutura (19,6 vs. 10,9%). Al año, se observó una recidiva en el grupo de sutura (1%) y ninguna en el grupo del pegamento. No obstante, la tasa de neuralgia crónica de intensidad moderada/severa fue de 2,9% en el grupo de pegamento y de 10,3% en el grupo de sutura (p=0,03) (AU)

Introduction: The use of synthetic glues has become normal practice in several surgicalfields. The objective of this study is to compare the short and medium term results of glue and conventional suture in the fixation of the prosthesis in open inguinal hernia repair with a plug and patch technique. Materials and methods: A comparative prospective study was conducted on 198 patients with a diagnosis of a non-recurrent inguinal hernia subjected to open surgery and randomly assigned to mesh fixation with cyanoacrylate glue (n = 101) or with suture (n = 98). The demographic characteristics, short-term complications, hospital stay, time off work, herniarecurrence, and chronic inguinal neuralgia, were analysed. Results: The overall morbidity was 13.9% in the glue group, and 30.9% in the suture group. No undue inflammatory reactions ormeshmigration were observed in the group. The postoperative stay was 14.7 h for the glue group, and 19.1 h in the suture group (P < .0001). No differences were found regarding days off work. The short-term morbidity was higher in the suture group (19.6% vs. 10.9%). After one year, there was one recurrence in the suture group (1%), and none in the glue group. However, the incidence of moderate/severe intensity chronic neuralgia was 2.9% in the glue group, and 10.3% in the suture group(P = .03).Conclusion: The use of cyanoacrylate is safe and effective in open inguinal hernia repair, with good results in the short and medium term (AU)

[Prosthetic material fixation in open inguinal hernioplasty: suture vs. synthetic glue]. / Fijación del material protésico en la hernioplastia inguinal abierta: sutura vs. cola sintética.

INTRODUCTION: The use of synthetic glues has become normal practice in several surgical fields. The objective of this study is to compare the short and medium term results of glue and conventional suture in the fixation of the prosthesis in open inguinal hernia repair with a plug and patch technique. MATERIALS AND METHODS: A comparative prospective study was conducted on 198 patients with a diagnosis of a non-recurrent inguinal hernia subjected to open surgery and randomly assigned to mesh fixation with cyanoacrylate glue (n=101) or with suture (n=98). The demographic characteristics, short-term complications, hospital stay, time off work, hernia recurrence, and chronic inguinal neuralgia, were analysed. RESULTS: The overall morbidity was 13.9% in the glue group, and 30.9% in the suture group. No undue inflammatory reactions or mesh migration were observed in the group. The post-operative stay was 14.7h for the glue group, and 19.1h in the suture group (P<.0001). No differences were found regarding days off work. The short-term morbidity was higher in the suture group (19.6% vs. 10.9%). After one year, there was one recurrence in the suture group (1%), and none in the glue group. However, the incidence of moderate/severe intensity chronic neuralgia was 2.9% in the glue group, and 10.3% in the suture group (P=.03). CONCLUSION: The use of cyanoacrylate is safe and effective in open inguinal hernia repair, with good results in the short and medium term.