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首页> 外文期刊>Surgical Endoscopy >Staple versus fibrin glue fixation in laparoscopic total extraperitoneal repair of inguinal hernia: a systematic review and meta-analysis.
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Staple versus fibrin glue fixation in laparoscopic total extraperitoneal repair of inguinal hernia: a systematic review and meta-analysis.

机译：腹股沟疝腹腔镜全腹膜外修补的吻合钉与纤维蛋白胶固定：系统评价和荟萃分析。

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Fixation of mesh is typically performed to minimize risk of recurrence in laparoscopic inguinal hernia repair. Mesh fixation with staples has been implicated as a cause of chronic inguinal pain. Our study aim is to compare mesh fixation using a fibrin sealant versus staple fixation in laparoscopic inguinal hernia and compare outcomes for hernia recurrence and chronic inguinal pain.PubMed was searched through December 2010 by use of specific search terms. Inclusion criteria were laparoscopic total extraperitoneal repair inguinal hernia repair, and comparison of both mesh fibrin glue fixation and mesh staple fixation. Primary outcomes were inguinal hernia recurrence and chronic inguinal pain. Secondary outcomes were operative time, seroma formation, hospital stay, and time to return to normal activity. Pooled odds ratios (OR) were calculated assuming random-effects models.Four studies were included in the review. A total of 662 repairs were included, of which 394 were mesh fixed by staples or tacks, versus 268 with mesh fixed by fibrin glue. There was no difference in inguinal hernia recurrence with fixation of mesh by staples/tacks versus fibrin glue [OR 2.13; 95% confidence interval (CI) 0.60-7.63]. Chronic inguinal pain (at 3 months) incidence was significantly higher with staple/tack fixation (OR 3.25; 95% CI 1.62-6.49). There was no significant difference in operative time, seroma formation, hospital stay, or time to return to normal activities.The meta-analysis does not show an advantage of staple fixation of mesh over fibrin glue fixation in laparoscopic total extraperitoneal inguinal hernia repair. Because fibrin glue mesh fixation with laparoscopic inguinal hernia repair achieves similar hernia recurrence rates compared with staple/tack fixation, but decreased incidence of chronic inguinal pain, it may be the preferred technique.
机译：通常进行网状固定以最小化腹腔镜腹股沟疝修补术中复发的风险。用钉书钉固定网孔已被认为是导致慢性腹股沟痛的原因。我们的研究目的是比较在腹腔镜腹股沟疝气中使用纤维蛋白密封剂的网状固定与钉书钉固定的情况，并比较疝气复发和慢性腹股沟痛的结果。PubMed在2010年12月之前使用特定搜索词进行了搜索。纳入标准为腹腔镜腹膜外全腹股沟疝修补术，以及网状纤维蛋白胶固定和网状钉固定的比较。主要结局是腹股沟疝复发和慢性腹股沟痛。次要结果是手术时间，血清肿形成，住院时间和恢复正常活动的时间。假设随机效应模型计算合并的优势比（OR），该评价包括四项研究。总共进行了662次修复，其中394次通过钉书钉或大头钉固定，而268次通过纤维蛋白胶固定。吻合钉/大头钉固定网孔的腹股沟疝复发率与纤维蛋白胶无差异[OR 2.13; 95％置信区间（CI）0.60-7.63]。钉书钉固定时，慢性腹股沟痛的发生率（3个月时）明显更高（OR 3.25; 95％CI 1.62-6.49）。手术时间，血清肿形成，住院时间或恢复正常活动的时间均无显着差异。荟萃分析在腹腔镜腹膜外腹股沟疝修补术中没有显示网状钉固定优于纤维蛋白胶固定的优势。由于腹腔镜腹股沟疝修补术的纤维蛋白胶网固定与钉/大头钉固定相比具有相似的疝复发率，但减少了慢性腹股沟痛的发生率，因此它可能是首选技术。

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