目前,腹股沟疝修补术主要通过应用有或没有缝线固定的网状假体进行。然而,关于不同手术入路的安全性和有效性的观点仍然部分不一致.在这项多中心回顾性研究中,三个无步骤的程序,即,用胶水固定网片,自抓网的应用,和特拉布科的技术,对1034例接受开放前路手术的原发性单侧非复杂性腹股沟疝患者进行了比较。患者相关特征,合并症,同时还检查了可能影响干预结局的药物.术后并发症的发生率,急性和慢性疼痛,并评估直至出院的时间。使用多变量逻辑回归比较调整其他危险因素的手术技术的比值比。标准/重网的应用,在特拉布科的技术中表演,被发现显著增加血肿的比值比(p=0.014),最值得注意的是,急性术后疼痛(p<0.001)。在临床参数中,抗栓治疗和大疝是血肿和住院时间较长的独立危险因素,而小疝是疼痛的独立预测因子。总的来说,我们的研究结果表明,Trabucco的技术不应该在大型疝和抗血栓治疗的患者中成为首选。
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.