Abstract:
Inguinal hernia repair, according to Desarda, is a pure tissue surgical technique using external oblique fascia to reinforce the posterior wall of the inguinal canal. This has provided an impetus for the rethinking of guideline adherence toward minimally invasive and mesh-based surgery of inguinal hernia. In this study, a retrospective analysis of this technique was conducted in two German hospitals. Between 6/2013 and 12/2020, 120 operations were performed. Analysis included patient characteristics, duration of operation, length of hospital stay, and perioperative complications. Data were used to achieve a matched-pair analysis comparing Desarda to laparoscopic transabdominal preperitoneal (TAPP) hernia repair. Propensity scores were calculated based on five preoperative variables, including sex, age, American Society of Anesthesiology classification, localization, and width of the inguinal hernia in order to achieve comparability. Additionally, we assessed pain level and quality of life (QoL) 12 months postoperatively. The focus of our study was a comparison of QoL to a reference population and TAPP cohort. The study population consisted of 106 male and 14 female patients, and the median age was 37.5 years. The median operation time was 50 min, and the median length of hospital stay was 2 days. At a follow-up of 17 months, the median recurrence rate was 0.8%, and two cases of chronic postoperative pain were recorded. Postoperative QoL does not significantly differ between Desarda and TAPP. In contrast, Desarda patients had a significantly higher QoL compared with the reference population. In summary, Desarda\'s procedure is a good option as a pure tissue method for inguinal hernia repair.
摘要:
腹股沟疝修补术,根据Desarda的说法,是一种使用外斜筋膜加固腹股沟管后壁的纯组织外科技术。这为重新思考腹股沟疝微创和网状手术的指南依从性提供了动力。在这项研究中,我们在两家德国医院对这项技术进行了回顾性分析.在2013年6月12日至2020年12月期间,进行了120次手术。分析包括患者特征,操作持续时间,住院时间,围手术期并发症。数据用于比较Desarda与腹腔镜经腹腹膜前(TAPP)疝修补术的配对分析。基于五个术前变量计算倾向评分,包括性,年龄,美国麻醉学会分类,本地化,和腹股沟疝的宽度,以达到可比性。此外,我们评估了术后12个月的疼痛水平和生活质量(QoL)。我们研究的重点是将QoL与参考人群和TAPP队列进行比较。研究人群包括106名男性和14名女性患者,中位年龄为37.5岁.中位手术时间为50min,中位住院时间为2天.在17个月的随访中,中位复发率为0.8%,记录2例慢性术后疼痛。Desarda和TAPP术后QoL没有显着差异。相比之下,与参考人群相比,Desarda患者的QoL明显更高。总之,Desarda的手术作为腹股沟疝修补术的纯组织方法是一个很好的选择。