Comparison of mesh fixation and non-fixation in laparoscopic totally extraperitoneal inguinal hernia repair.
Hernia
; 21(4): 543-548, 2017 08.
Article
em En
| MEDLINE
| ID: mdl-28214943
ABSTRACT
PURPOSE:
The purpose of this study was to compare laparoscopic total extraperitoneal (TEP) hernia repair procedures with or without mesh fixation for non-recurrent inguinal hernia.METHODS:
100 male patients with non-recurrent inguinal hernia (62 unilateral and 38 bilateral) were included in the study. The patients were randomly assigned to either the mesh fixation group (n = 50) or the mesh non-fixation group (n = 50). The operative and follow-up data of the two groups were analyzed and compared in terms of recurrence rates, postoperative pain, length of hospital stay, and postoperative changes in testicular arterial blood flow.RESULTS:
Pain scores were significantly higher in the mesh fixation group prior to discharge and at the 1st postoperative month (p = 0.034 and 0.001, respectively). Necessity to use narcotic analgesics was higher in the fixation group prior to discharge (p = 0.025). Urinary retention was significantly more frequent in the fixation group than in the non-fixation group. (p = 0.007). The mean operative time and length of hospital stay were similar in both groups. Preoperative and postoperative measurements of testicular arterial blood flow showed a substantial but not statistically significant difference for the frequency of impairment (14.2% in the fixation group and 5.8% in the non-fixation group) (p = 0.176). At long-term follow-up, no recurrence and no nerve injury were determined.CONCLUSION:
Fixation of the mesh to the abdominal wall has been associated with various postoperative complications for no additional benefit in lowering recurrence rates. For non-recurrent inguinal hernia, non-fixation of the mesh is safe and reliable. Further studies with larger sample sizes are necessary for subgroup analyses.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dor Pós-Operatória
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Telas Cirúrgicas
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Retenção Urinária
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Laparoscopia
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Herniorrafia
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Hérnia Inguinal
Tipo de estudo:
Clinical_trials
Limite:
Adult
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Hernia
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Turquia
País de publicação:
FR
/
FRANCE
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FRANCIA
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FRANÇA