García PR, Casanova PPA

Language: Spanish
References: 16
Page: 25-29
PDF size: 46.83 Kb.

ABSTRACT

Objective: To assess the simultaneous treatment to repair bilateral inguinal hernias under local anesthesia using a tension-free technique.
Design: Retrospective study without control group.
Setting: Second level health care general hospital.
Patients and methods: We studied retrospectively the data obtained from 36 patients subjected simultaneously to surgery of bilateral hernia defect in the groin region, from January 1998 to January 2001, in a General Hospital, using a tension-free technique. We analyzed: surgical risk according to the ASA classification, type of hernia (according to the Nyhus classification) surgical time, post-operative follow-up, and complications. All patients received local anesthesia with 1% lidocaine and 0.25% bupivacaine. Central tendency measures were used for the analysis.
Results: The average age of the patients was 47.8 years (range of 22 to 76), predominating 3B hernias, mean surgical time was of 78 minutes, and follow-up time was 2.1 years. Twenty percent of the patients presented some form of complication, representing 10% of the performed herniorrhaphies; the most frequent complication was hematoma of the surgical wound. No recurrences have occurred yet.
Conclusion: The simultaneous repair of hernia defects using local anesthesia and a tension free technique was successful in this group of patients.

REFERENCES

1. Nyhus LM. Ubiquitous use of prosthetic mesh in inguinal hernia repair: The dilemma. Hernia 2000; 4: 184-6.

2. Schumpelick V. Does every hernia demand a mesh repair? A critical review. Hernia 2001; 5: 5-8.

3. Gilbert AI, Felton LL. Infections in inguinal hernia repair considering biomaterials and antibiotics. Surg Gynecol Obstet 1993; 177: 126-30.

4. Golstein HS. Selecting the right mesh. Hernia 1999; 3: 23-6.

5. Lorenz D, Stark E, Oestreich K, Richter A. Laparoscopic hernioplasty versus conventional hernioplasty (Shouldice): results of a prospective randomized trial. World J Surg 2000; 24: 739-46.

6. Deysine M, Soroff HS. Must we specialize herniorrhaphy for better results? Am J Surg 1990; 160: 239-41.

7. Schofield PF. Inguinal hernia: medicolegal implications. Am R Coll Surg Engl 2000; 82: 109-10.

8. Hernández GP, Quitans RA. Early complications in tension-free hernioplasty: comparison between ambulatory and short-stay surgery. Hernia 2000; 4: 238-41.

9. Crawford DL, Phillips EH. Laparoscopic repair and groin hernia surgery. Surg Clin North Am 1998; 78: 1047-62.

10. Abrahamson J. Hernias. In: Zinner MJ. Maingot´s abdominal operations. Vol 1. 10th ed. Stanford, CT: Appleton Lange; 1997: 479.

11. Welsh DRJ, Alexander MAJ. The Shouldice repair. Surg Clin North Am 1993; 73: 451-69.

12. Amid PK, Shulman AG, Lichtenstein IL. Local anesthesia for inguinal hernia repair step-by-step procedure. Ann Surg 1994; 220: 735-7.

13. Velasco JM, Gelman C, Vallina VL. Preperitoneal bilateral inguinal herniorrhaphy evolution of a technique from conventional to laparoscopic. Surg Endosc 1996; 10: 122-7.

14. Malazgirt Z, Ozkan K, Dervisoglu A, Kaya E. Comparison of Stoppa and Lichtenstein techniques in the repair of bilateral inguinal hernia. Hernia 2000; 4: 264-7.

15. Tocchi A, Liotta G, Mazzoni G, Lepre L, Costa G, Miccini M. Anterior approach and simultaneous tension-free repair of bilateral inguinal hernia under local anesthesia. G Chir 1999; 20: 429-32.

16. Maggiore D, Muller G, Hafanaki J. Bassini vs. Lichtenstein: two basic techniques for inguinal hernia treatment. Hernia 2001; 5: 21-4.