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

• Authors: Łukasz Łebkowski , Paweł Białek , Mariusz Uryszek , Małgorzata Polańska , Robert Proczka , Jerzy Polański
• Languages of publication: EN

Abstracts

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.

Keywords

EN

hernia; mesh; technique Lichtenstein

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2008
• Volume: 80
• Issue: 12
• Pages: 653-658

Dates

published

1 - 12 - 2008

online

4 - 5 - 2010

Contributors

author

Łukasz Łebkowski

• Department of Colorectal Cancer Surgery, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw

author

Paweł Białek

• 2 Department of General, Oncological and Vascular Surgery, 2 Faculty of Medicine, Medical University in Warsaw

author

Mariusz Uryszek

• 2 Department of General, Oncological and Vascular Surgery, 2 Faculty of Medicine, Medical University in Warsaw

author

Małgorzata Polańska

• 2 Department of General, Oncological and Vascular Surgery, 2 Faculty of Medicine, Medical University in Warsaw

author

Robert Proczka

• 2 Department of General, Oncological and Vascular Surgery, 2 Faculty of Medicine, Medical University in Warsaw

author

Jerzy Polański

• 2 Department of General, Oncological and Vascular Surgery, 2 Faculty of Medicine, Medical University in Warsaw

References

• McCormack K, Scott NW, Go PM et al.: Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 2003; (1): CD001785. Review.
• Ścierski A, Roechte F: Przydatność badań ultraso-nograficznych w diagnostyce przepuklin pachwinowych. Wideochirurgia i inne techniki maloinwazyjne 2007; 2(6): 58-65.
• Renzulli P, Frei E, Schafer M et al.: Preoperative Nyhus classification of inguinal hernias and type-related individual hernia repair. A case for diagnostic laparoscopy. Surg Laparosc Endosc 1997; 7(5): 373-77.[Crossref]
• Rutkow IM, Robbins AW: Classification systems and groin hernias. Surg Clin North Am 1998; 78(6): 1117-27.[PubMed][Crossref]
• Nyhus LM: The recurrent groin hernia: therapeutic solutions. World J Surg 1989; 13(5): 541-44.[Crossref][PubMed]
• Poobalan AS, Bruce J, King PM et al.: Chronic pain and quality of life following open inguinal hernia repair. Br J Surg 2001; 88(8): 1122-26.
• Koninger J, Redecke J, Butters M. Chronic pain after hernia repair: a randomized trial comparing Shouldice, Lichtenstein and TAPP. Langenbecks Arch Surg 2004; 389(5): 361-65. Epub 2004 Jul 9.
• Bay-Nielsen M, Nilsson E, Nordin P et al.: Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males. Br J Surg 2004; 91(10): 1372-76.
• Kumar S, Wilson RG, Nixon SJ et al.: Chronic pain after laparoscopic and open mesh repair of groin hernia. Br J Surg 2002; 89(11): 1476-79.
• Aasvang EK, Bay-Nielsen M, Kehlet H: Pain and functional impairment 6 years after inguinal herniorrhaphy. Hernia. 2006; 10(4): 316-21. Epub 2006 May 19.[Crossref]
• Franneby U, Sandblom G, Nordin P et al.: Risk factors for long-term pain after hernia surgery. Ann Surg 2006; 244(2): 212-19.
• O'Dwyer PJ, Alani A, McConnachie A: Groin hernia repair: postherniorrhaphy pain. World J Surg 2005; 29(8): 1062-65.
• Delikoukos S, Lavant L, Hlias G et al.: The role of hernia sac ligation in postoperative pain in patients with elective tension-free indirect hernia repair: a prospective randomized study. Hernia 2007; 11(5): 425-28. Epub 2007 Jun 27[Crossref]
• Grant AM, Scott NW, O'Dwyer PJ: Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 2004; 91(12): 1570-74.
• Alfieri S, Rotondi F, Di Giorgio A et al.: Influence of preservation versus division of ilioinguinal, iliohypogastric, and genital nerves during open mesh herniorrhaphy: prospective multicentric study of chronic pain. Ann Surg 2006; 243(4): 553-58.
• Bartlett DC, Porter C, Kingsnorth AN: A pragmatic approach to cutaneus nerve division during open inguinal hernia repair. Hernia 2007, 11(3); 243-66. Epub 2007 Mar 20.[Crossref]
• Ravichandran D, Kalambe BG, Pain JA: Pilot randomized controlled study of preservation or division of ilioinguinal nerve in open mesh repair of inguinal hernia. Br J Surg 2000; 87(9): 1166-67.
• Picchio M, Palimento D, Attanasio U et al.: Randomized controlled trial of preservation Or elective divisi on of ilioinguinal nerve on open inguinal hernia rep air with polipropylene mesh. Arch Surg 2004, 139(7): 788-88.
• Michalik M, Frask A, Klawiter A: Operacje laparoskopowe przepuklin pachwinowych. Wideo-chirurgia i inne techniki małoinwazyjne 2007; 2 (4): 150-55.

Identifiers

DOI

10.2478/v10035-008-0092-4