背景:聚丙烯材料通常用于疝修补术中的后壁重建,与Shouldice医院使用的经典描述的不锈钢丝相反。进行这项研究是为了评估使用聚丙烯或不锈钢丝缝线进行Shouldice修复结果的可能差异。
方法:对2021年12月6日至2022年9月1日在Shouldice医院接受选择性单侧Shouldice原发性腹股沟疝修补术的连续患者进行前瞻性随访。数据来自随访电话以及手动检查患者的图表。主要目的是确定聚丙烯的使用是否不劣于不锈钢丝的使用,关于Shouldice原发性腹股沟疝修补术后最低随访1年的患者报告的复发率。
结果:共通过电话联系了1120名患者(聚丙烯:560;不锈钢丝:560)。中位随访期为16个月(四分位距:15-18)。在22例(1.96%)中,诊断出手术部位感染。患者总共报告了18例复发(1.6%)。两组之间没有统计学差异(聚丙烯:7(1.25%)与不锈钢丝:11(1.96%),p>0.05)为复发率。
结论:在选择性单侧腹股沟疝修补术后的中位随访期为16个月时,使用聚丙烯的复发率不劣于使用不锈钢丝。这一发现可能会鼓励其他不容易使用不锈钢丝进行Shouldice修复的中心。
BACKGROUND: Polypropylene material is commonly used for posterior wall reconstruction in hernia repair, in contrast with the classically described stainless-steel wire used at Shouldice Hospital. This
study was conducted to evaluate possible differences in Shouldice Repair outcomes using
polypropylene or stainless-steel wire sutures.
METHODS: A prospective follow-up of consecutive patients who underwent elective unilateral Shouldice primary inguinal hernia repair at Shouldice Hospital between December 6, 2021, and September 1, 2022, was conducted. Data was collected from follow-up telephone calls as well as manually reviewing patient\'s charts. The primary objective was to determine whether the use of
polypropylene was non-inferior to the use of stainless-steel wire, regarding the recurrence rate reported by the patients with a minimum follow-up of 1 year after Shouldice primary inguinal hernia repair.
RESULTS: A total of 1120 patients were contacted by telephone (
polypropylene: 560; stainless-steel wire: 560). The median follow-up period was 16 months (interquartile range: 15-18). In 22 (1.96%) cases a surgical site infection was diagnosed. There was a total of 18 recurrences reported by the patients (1.6%). There was no statistical difference between the groups (
polypropylene: 7 (1.25%) vs. stainless steel wire: 11 (1.96%), p > 0.05) for the recurrence rate.
CONCLUSIONS: The use of polypropylene is non-inferior to the use of stainless-steel wire regarding recurrence rate at a median follow-up period of 16 months after elective unilateral Shouldice primary inguinal hernia repair. This finding may encourage other centers where stainless-steel wire is not easily available to perform the Shouldice Repair.