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首页> 外文期刊>Surgical Endoscopy >Effectiveness and safety of n-butyl-2-cyanoacrylate medical adhesive for noninvasive patch fixation in laparoscopic inguinal hernia repair
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Effectiveness and safety of n-butyl-2-cyanoacrylate medical adhesive for noninvasive patch fixation in laparoscopic inguinal hernia repair

机译：N--2-氰基丙烯酸正丁酯医用胶粘剂在腹腔镜腹股沟疝修补术中无创贴剂固定的有效性和安全性

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Background: Our purpose was to compare the recurrence rate and other clinical outcomes of laparoscopic (LS) transabdominal preperitoneal (TAPP) inguinal hernia repair using n-butyl-2-cyanoacrylate (NBCA) for mesh fixation with those of no mesh fixation and mesh fixation with titanium spiral tacks (ST). Methods: The medical records of patients who received LS TAPP inguinal hernia repair between 2009 and 2012 at our institution were reviewed. Patients were included if the received LS TAPP with either no mesh fixation, mesh fixation with NBCA only, fixation with ST only, or fixation with NBCA + ST. Outcome measures were operation time, postoperative length of stay, visual analogue scale (VAS) pain score 24 h after surgery, postoperative complications, and hernia recurrence. Results: A total of 1,027 TAPP cases were included. In 552 cases, meshes were fixed with NBCA only, in 89 cases only ST were used, in 47 cases ST and NBCA were used, and in 339 cases meshes were not fixed. The groups were comparable with respect to demographic and clinical characteristics. No surgical complications occurred in any group. VAS pain scores were significantly lower in the nonfixation and NBCA only groups (1.4 ± 0.6 and 1.3 ± 0.6, respectively) than in the ST and NBCA + ST groups (2.2 ± 0.9 and 2.2 ± 0.7, respectively; P = 0.001). The mean follow-up duration was ~19 months. At the final follow-up, no wound infections or hernia recurrences had occurred in any of the groups. No occurrence of chronic pain was noted in the nonfixation and NBCA only groups, whereas two cases (2.2%) were noted in the ST group and one case (2.1%) in the NBCA + ST group (P = 0.005). Conclusions: The use of NBCA medical adhesive for noninvasive patch fixation in laparoscopic hernia repair (TAPP) is effective and safe.
机译：背景：我们的目的是比较使用2-氰基丙烯酸正丁酯（NBCA）进行腹腔镜（LS）腹膜前腹膜（TAPP）腹股沟疝修补术的复发率和其他临床结局，以及无网状固定和网状固定的情况带有钛螺旋钉（ST）。方法：回顾性分析我院2009年至2012年间接受LS TAPP腹股沟疝修补术的患者的病历。如果接受的LS TAPP没有网状固定，仅用NBCA进行网状固定，仅用ST进行固定或用NBCA + ST进行固定，则将患者包括在内。结果指标包括手术时间，术后住院时间，术后24 h视觉模拟量表（VAS）疼痛评分，术后并发症和疝复发。结果：总共包括1,027例TAPP病例。在552例中，仅使用NBCA固定网格，在89例中仅使用ST，在47例中使用了ST和NBCA，在339例中未固定网格。两组在人口统计学和临床​​特征方面具有可比性。任何一组均未发生手术并发症。非固定组和仅NBCA组的VAS疼痛评分显着低于ST组和NBCA + ST组（分别为2.2±0.9和2.2±0.7; P = 0.001）（分别为1.4±0.6和1.3±0.6）。平均随访时间为〜19个月。在最后的随访中，所有组均未发生伤口感染或疝气复发。非固定组和仅NBCA组未发现慢性疼痛发生，而ST组为2例（2.2％），NBCA + ST组为1例（2.1％）（P = 0.005）。结论：NBCA医用粘合剂在腹腔镜疝气修补术（TAPP）中的无创膜固定中的应用是安全有效的。

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