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Results of the Inguinal Hernia Repair With The Use of Mesh. Analysis of the Operation Technique Influence on Post-Operative Complications

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Łebkowski Ł., Białek P., Uryszek M., Polańska M., Proczka R., Polański J.
Polish Journal of Surgery
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2008
|
vol. 80
|
issue 12
653-658
EN
The aim of the study was to demonstrate the relation between the operation technique and the early and late complications after the primary and secondary inguinal hernia repairs with the use of artificial material.Material and methods. There were 103 patients qualified for the research from among 140 patients operated within the period of 2003 - 2005. In all patients the same kind of mesh was used (100% Prolene). The operators were asked to fill in a special, original questionnaire. In all patients hernia type was classified during the repair with the use of Nyhus classification, seven key technical details of the treatment were described, subsequently the most frequent post-operative complications and inexpedient symptoms were evaluated - just after the operation and in 18 months time. Statistic one-dimension analysis of X2 method was applied or Fisher's exact test. After indication of the links, multidimensional analysis of logistic regression was used.Results. Based on the multidimensional analysis of logistic regression the links between technical details of the treatment and complications were evaluated. The analysis shows that only high tension has a significant influence on complications' emergence (p<0.0001). Precision of the model amounts to 71%. Additionally each particular complication was analyzed separately.Conclusions. Based on above mentioned results the operation technique algorithm was created with the smallest number of complications. From among analyzed technical details of the operation the special attention should be put at those which are directly and indirectly connected to the mesh binding. The lack of its tension is assumed to be the key factor of the whole procedure that minimizes one of the most serious post-operative complication which is the chronic pain.
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