|
1
|
Baldini E, Lori E, Morini C, Palla L, Coletta D, De Luca GM, Giraudo G, Intini SG, Perotti B, Sorge A, Sozio G, Arganini M, Beltrami E, Pironi D, Ranalli M, Saviano C, Patriti A, Usai S, Vernaccini N, Vittore F, D’Andrea V, Nardi P, Sorrenti S, Palumbo P. Sutureless Repair for Open Treatment of Inguinal Hernia: Three Techniques in Comparison. J Clin Med 2024; 13:589. [PMID: 38276095 PMCID: PMC10816828 DOI: 10.3390/jcm13020589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Currently, groin hernia repair is mostly performed with application of mesh prostheses fixed with or without suture. However, views on safety and efficacy of different surgical approaches are still partly discordant. In this multicentre retrospective study, three sutureless procedures, i.e., mesh fixation with glue, application of self-gripping mesh, and Trabucco's technique, were compared in 1034 patients with primary unilateral non-complicated inguinal hernia subjected to open anterior surgery. Patient-related features, comorbidities, and drugs potentially affecting the intervention outcomes were also examined. The incidence of postoperative complications, acute and chronic pain, and time until discharge were assessed. A multivariate logistic regression was used to compare the odds ratio of the surgical techniques adjusting for other risk factors. The application of standard/heavy mesh, performed in the Trabucco's technique, was found to significantly increase the odds ratio of hematomas (p = 0.014) and, most notably, of acute postoperative pain (p < 0.001). Among the clinical parameters, antithrombotic therapy and large hernia size were independent risk factors for hematomas and longer hospital stay, whilst small hernias were an independent predictor of pain. Overall, our findings suggest that the Trabucco's technique should not be preferred in patients with a large hernia and on antithrombotic therapy.
Collapse
Affiliation(s)
- Enke Baldini
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Eleonora Lori
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Carola Morini
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Luigi Palla
- Department of Public Health and Infectious Diseases, “Sapienza” University of Rome, 00161 Rome, Italy;
| | - Diego Coletta
- United Hospitals of Northern Marche (AOORMN)—Pesaro, 61121 Pesaro, Italy; (D.C.); (A.P.)
| | - Giuseppe M. De Luca
- Unit of Academic General Surgery “V. Bonomo”, University of Bari, 70124 Bari, Italy; (G.M.D.L.); (F.V.)
| | - Giorgio Giraudo
- Department of Surgery, Santa Croce e Carle Hospital (ASO) of Cuneo, 12100 Cuneo, Italy; (G.G.); (E.B.)
| | - Sergio G. Intini
- Department of Surgery, S. Maria Della Misericordia Hospital, ASUFC of Udine, 33100 Udine, Italy; (S.G.I.); (N.V.)
| | - Bruno Perotti
- Department of Surgery, Versilia Hospital of Viareggio, 55049 Camaiore, Italy; (B.P.); (M.A.)
| | - Angelo Sorge
- Day Surgery P.O.S. Giovanni Bosco, 80144 Naples, Italy; (A.S.); (C.S.)
| | - Giampaolo Sozio
- Department of Surgery, Alta Val D’Elsa Hospital of Poggibonsi—Siena, 53036 Poggibonsi, Italy; (G.S.); (M.R.)
| | - Marco Arganini
- Department of Surgery, Versilia Hospital of Viareggio, 55049 Camaiore, Italy; (B.P.); (M.A.)
| | - Elsa Beltrami
- Department of Surgery, Santa Croce e Carle Hospital (ASO) of Cuneo, 12100 Cuneo, Italy; (G.G.); (E.B.)
| | - Daniele Pironi
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Massimo Ranalli
- Department of Surgery, Alta Val D’Elsa Hospital of Poggibonsi—Siena, 53036 Poggibonsi, Italy; (G.S.); (M.R.)
| | - Cecilia Saviano
- Day Surgery P.O.S. Giovanni Bosco, 80144 Naples, Italy; (A.S.); (C.S.)
| | - Alberto Patriti
- United Hospitals of Northern Marche (AOORMN)—Pesaro, 61121 Pesaro, Italy; (D.C.); (A.P.)
| | - Sofia Usai
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Nicola Vernaccini
- Department of Surgery, S. Maria Della Misericordia Hospital, ASUFC of Udine, 33100 Udine, Italy; (S.G.I.); (N.V.)
| | - Francesco Vittore
- Unit of Academic General Surgery “V. Bonomo”, University of Bari, 70124 Bari, Italy; (G.M.D.L.); (F.V.)
| | - Vito D’Andrea
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Priscilla Nardi
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Salvatore Sorrenti
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| | - Piergaspare Palumbo
- Department of Surgery, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (E.L.); (C.M.); (D.P.); (S.U.); (V.D.); (P.N.); (S.S.)
| |
Collapse
|
|
2
|
Dams A, Vankeirsbilck J, Poelmans S, Kerschaever I, Borreman P, Berwouts L, De Mulder W, Colle J, Beunis A, Dhooghe V, Van De Winkel N, Allaeys M, Ruyssers M, Haesen D, Van der Speeten K. Cyanoacrylate mesh fixation for laparoscopic inguinal hernia repair: a prospective, multicenter, single-arm study. Surg Endosc 2023; 37:9105-9115. [PMID: 37798529 DOI: 10.1007/s00464-023-10439-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/02/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Inguinal hernia repair is among the most frequently performed surgical procedures. Alternatives to penetrating mesh fixation, such as surgical glue, are being investigated for their potential benefit in reducing chronic pain. The aim of this study was to assess the efficacy of the n-hexyl cyanoacrylate glue Ifabond™ for mesh fixation in laparoscopic inguinal hernia repair. METHODS This prospective, multicenter, single-arm study collected data from laparoscopic inguinal hernia repairs using Ifabond™ (Peters Surgical, Boulogne-Billancourt Cedex, France) and a standard [Promesh® SURG ST (Peters Surgical)/Biomesh® P1 (Cousin Biotech, Wervicq-Sud, France)] or lightweight [Promesh® SURG LI (Peters Surgical)/Premium® Implant (Cousin Biotech)] polypropylene mesh. The primary endpoint was postoperative pain [100-scale Visual Analog Scale (VAS)]. Secondary endpoints were complications, hernia recurrences, and quality of life (QoL) (EQ-5D-3L health index and EQ-VAS). Patients were followed up at 5 weeks and 12 months after surgery. RESULTS Six-hundred and thirteen patients underwent laparoscopic inguinal hernia repair. Postoperative pain decreased at 5-week (3.97 ± 10.04; p < 0.0001) and 12-month (3.83 ± 11.26; p < 0.0001) follow-up compared with before surgery (26.96 ± 19.42). One hundred and fifteen patients (13.74%) experienced chronic pain in the groin at 12-month follow-up, of whom 14 (2.67%) required analgesics. There were 6 patients with major morbidities and one patient died of an unrelated cause. Two hernia recurrences occurred within 12-month follow-up. Patients' QoL increased from an EQ-5D-3L index score of 0.82 ± 0.19 preoperatively to 0.90 ± 0.15 at 5 weeks (p < 0.0001) and 0.92 ± 0.15 at 12 months after surgery (p < 0.0001). The EQ-VAS general health scoring increased from 79.03 ± 12.69 preoperatively to 84.31 ± 9.97 at 5-week (p < 0.0001) and 84.16 ± 14.48 at 12-month follow-up (p < 0.0001). CONCLUSIONS Ifabond™ (Peters Surgical) is a safe, reliable, and feasible fixation method for laparoscopic inguinal hernia repair with a very high surgeon satisfaction score, improved patients' QoL, and comparable risk of developing chronic pain and postoperative complications as described in the literature.
Collapse
Affiliation(s)
- Anne Dams
- Department of Abdominal Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Joost Vankeirsbilck
- Department of General and Abdominal Surgery, Regional Hospital Heilig Hart, Tienen, Belgium
| | - Stephan Poelmans
- Department of General and Abdominal Surgery, Regional Hospital Heilig Hart, Tienen, Belgium
| | - Ivan Kerschaever
- Department of General and Abdominal Surgery, Regional Hospital Heilig Hart, Tienen, Belgium
| | - Philippe Borreman
- Department of General and Abdominal Surgery, Regional Hospital Heilig Hart, Tienen, Belgium
| | - Luc Berwouts
- Department of General Surgery, Hospital Sint-Vincentius, Deinze, Belgium
| | - Wim De Mulder
- Department of General Surgery, Hospital Sint-Vincentius, Deinze, Belgium
| | - Julien Colle
- Department of General Surgery, Hospital Sint-Vincentius, Deinze, Belgium
| | - Anthony Beunis
- Department of Abdominal Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vicky Dhooghe
- Department of Abdominal Surgery, Antwerp University Hospital, Edegem, Belgium
| | | | - Mathias Allaeys
- Department of Abdominal Surgery, UZ Brussel, Brussels, Belgium
| | | | | | - Kurt Van der Speeten
- Department of Abdominal Surgery, Ziekenhuis Oost-Limburg, Genk, Belgium.
- Faculty of Medicine, Hasselt University, Diepenbeek, Belgium.
| |
Collapse
|