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首页> 外文期刊>Surgical Endoscopy >Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation.
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Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation.

机译：腹腔镜腹疝修补术中的网状皱缩和疼痛：比较缝合线与大头钉网状固定的随机临床试验。

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摘要

BACKGROUND: Mesh fixation during laparoscopic ventral hernia repair can be performed using transfascial sutures or metal tacks. The aim of the present study is to compare mesh shrinkage and pain between two different techniques of mesh fixation in a prospective randomized trial. METHODS: A randomized trial was performed. Patients with ventral hernia of maximal diameter 8 cm were assigned to mesh fixation using either transfascial nonabsorbable sutures or metal tacks for fixation of a parietene composite mesh. The borders of the mesh were marked using clips, and radiological images in prone position were used for assessment of mesh size and location. The primary endpoint was mesh shrinkage; secondary endpoints included postoperative pain, mesh dislocation, and surgical morbidity. RESULTS: Demographic parameters were similar in both groups. A total of 40 patients were randomized, and 36 patients were available for follow-up. There was one hernia recurrence in each group. Pain was significantly higher following suture fixation after 6 weeks, but no difference was found after 6 months. Mesh shrinkage after 6 months was significantly higher using tacks for mesh fixation. CONCLUSIONS: Transfascial sutures are associated with more pain within the first 6 postoperative weeks and less mesh shrinkage after 6 months compared with mesh fixation using metal tacks.
机译：背景：腹腔镜腹疝修补术中的网状固定可以使用经筋膜缝合或金属钉进行。本研究的目的是在一项前瞻性随机试验中比较两种不同的网眼固定技术之间的网眼收缩和疼痛。方法：进行了一项随机试验。将最大直径为8 cm的腹侧疝患者使用网状筋膜不可吸收缝合线或金属钉固定网状复合材料网片，以固定网片。用夹子标记网格的边界，俯卧位的放射图像用于评估网格的大小和位置。主要终点是网眼收缩。次要终点包括术后疼痛，网状脱位和手术发病率。结果：两组的人口统计学参数相似。共有40例患者被随机分组​​，另有36例患者可以进行随访。每组有一次疝气复发。 6周后缝合固定后疼痛明显升高，但6个月后未发现差异。使用大头钉固定网眼后，六个月后的网眼收缩率明显更高。结论：与使用金属钉固定网孔相比，经筋膜缝合术在术后前6周内疼痛更多，在6个月后网孔缩小较少。

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