Effect of direct defect closure during laparoscopic inguinal hernia repair ('TEP/TAPP plus' technique) on post-operative outcomes
| Autor: | S Malik, Sujith Wijerathne, C Yeo, D. Lomanto, F Usmani, J. Rao |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Operative Time Hernia Inguinal 030230 surgery law.invention 03 medical and health sciences Defect closure Postoperative Complications 0302 clinical medicine Randomized controlled trial Recurrence law Humans Medicine Prospective Studies Post operative Herniorrhaphy Aged Singapore Sutures business.industry Suture Techniques Middle Aged Surgical Mesh medicine.disease Hernia repair Surgery Inguinal hernia Seroma surgical procedures operative 030220 oncology & carcinogenesis Female Laparoscopy business Complication Abdominal surgery |
| Zdroj: | Hernia. 24:167-171 |
| ISSN: | 1248-9204 1265-4906 |
| Popis: | Seroma formation and recurrence in large inguinal hernia still remain an important clinical complication despite decades since the advent of mesh repair. In our prospective comparative analysis, we want to evaluate the effect of direct hernia defect closure on surgical outcomes in patients undergoing laparoscopic inguinal hernia repair in two tertiary care institutions in Singapore. The direct hernia defects were closed with non-absorbable sutures incorporating the pseudosac. A group of 241 patients underwent laparoscopic inguinal hernia mesh repair for a total of 378 direct defects from April 2014 to July 2018. Of these patients, 98 (40.6%) patients underwent hernia repair without closure of their direct defect while 143 (59.4%) patients underwent direct defect closure. No significant differences were observed between the two patient populations’ demographic information and the mean operative time. A total of 219 direct defects were closed and 159 direct defects were not repaired. Compared to the group that did not undergo direct defect closure, the group that had closure of the direct defects demonstrated a statistically significant reduction in recurrence (4.4% versus 0.9%, p = 0.036) and seroma formation (12.6% versus 6.4%, p = 0.045). Direct defect closure has proven to be effective in reducing recurrence and seroma formation post-operatively in patients undergoing laparoscopic inguinal hernia repair. Randomized controlled trials will be required to further evaluate these outcomes. |
| Databáze: | OpenAIRE |
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