Barragán PR, Cendejas HR, Muñoz CW, Pérez FUA

Language: Spanish
References: 18
Page: 11-16
PDF size: 219.96 Kb.

ABSTRACT

Introduction: Postoperative pain secondary to the use of staples in inguinal hernia repair is a significant problem in this procedure. The use of tissue adhesives is an adequate alternative for this purpose, providing less postoperative pain, early reincorporation into work activities and without an increase in the percentage of recurrences. In this study, we evaluated the efficacy, safety, patient satisfaction, and recurrences with the use of N-2 butyl-cyanoacrylate (Glubran2^®) for the fixation of the mesh in TAPP laparoscopic inguinal hernia repair. Material and methods: This is a prospective and observational study of patients in which the results were documented, who underwent TAPP inguinal hernia repair and the mesh was fixed with N-2 butyl-cyanoacrylate; evaluating postoperative pain using a visual analog scale, SF-36 questionnaire in the preoperative and postoperative at three and six months, satisfaction scale of the surgery using the «Carolinas comfort scale» at three and six months postoperatively, reintegration time to their daily activities and recurrences at six and 12 months of follow-up. Results: 35 inguinal hernia repairs were operated in 21 patients, 19 (90.48%) men, 2 (9.52%) women. The average age was 47.71 years. In the preoperative period, 95.2% of the patients had limitation to carry out their daily activities and usual work, and in the postoperative period, 95.2% of the patients were without limitation to carry out their activities. The average in pain at 24 hours was 1.5 and 0 at seven days. The average on reintegration to activities was 8.4 days. No recurrence was found at 12 months of follow-up. Conclusions: The use of the adhesive is a safe alternative for the fixation of the mesh in laparoscopic inguinal hernia repair, with minimal postoperative pain, early reintegration to work activities, with a great patient satisfaction and without an increase in the percentage of recurrences so far, at 1 year of follow-up.

REFERENCES

1. Kaul A, Hutfless S, Le H, Hamed SA, Tymitz K, Nguyen H et al. Staple versus fibrin glue fixation in laparoscopic total extraperitoneal repair of inguinal hernia: a systematic review and meta-analysis. Surg Endosc. 2012; 26: 1269-1278.

2. Mahanta A, Mishra RK. Tissue glue in laparoscopic inguinal hernia repair: a retrospective comparative analysis. WJOLS. 2010; 3: 165-174.

3. Kukleta JF, Freytag C, Weber M. Efficiency and safety of mesh fixation in laparoscopic inguinal hernia repair using n-butyl cyanoacrylate: long-term biocompatibility in over 1,300 mesh fixations. Hernia. 2012; 16: 153-162.

4. Moreno-Egea A. Adhesivos tisulares sintéticos: lo que un cirujano de hernias y pared abdominal debe saber. Rev Hispanoam Hernia. 2013; 1: 117-127.

5. Testini M, Lissidini G, Poli E, Gurrado A, Lardo D, Piccinni G. A single-surgeon randomized trial comparing sutures, N-butyl-2-cyanoacrylate and human fibrin glue for mesh fixation during primary inguinal hernia repair. Can J Surg. 2010; 53: 155-160.

6. Moreno-Egea A. ¿Es segura la hernioplastia sin sutura como opción para tratar las hernias de pared abdominal? Estudio prospectivo con un adhesivo tisular sintético (n-hexil-α-cianoacrilato). Cir Esp. 2013; 91: 243-249.

7. Kim-Fuchs C, Angst E, Vorburger S, Helbling C, Candinas D, Schlumpf R. Prospective randomized trial comparing sutured with sutureless mesh fixation for Lichtenstein hernia repair: long-term results. Hernia. 2012; 16: 21-27.

8. Valdovinos GC, Saldívar RF, Díaz CC, Athié GC. Calidad de vida en pacientes operados de plastia inguinal mediante short form 36 (SF-36). Cir Gen. 2012; 34: 169-173.

9. Heniford BT, Lincourt AE, Walters AL, Colavita PD, Belyansky I, Kercher KW et al. Carolinas comfort scale as a measure of hernia repair quality of life: a reappraisal utilizing 3788 international patients. Ann Surg. 2018; 267: 171-176.

10. CNPSS: Catálogo de Servicios Esenciales en Salud: Comisión Nacional de Protección Social en Salud. México, Dirección General de Gestión en Servicios de Salud, 2004. pp. 1-51.

11. Mayagoitia JC. Hernias de la pared Abdominal. Tratamiento actual. Tercera ed. Editorial Alfil: 2015. pp. 19-29 y 209, 264.

12. Wang M, Tian M, Zhao X, Nie Y, Chen J, Shen Y. Effectiveness and safety of n-butyl-2-cyanoacrylate medical adhesive for noninvasive patch fixation in laparoscopic inguinal hernia repair. Surg Endosc. 2013; 27: 3792-3798.

13. Antoniou SA, Köhler G, Antoniou GA, Muysoms FE, Pointner R, Granderath FA. Meta-analysis of randomized trials comparing nonpenetrating vs mechanical mesh fixation in laparoscopic inguinal hernia repair. Am J Surg. 2016; 211: 239-249.

14. Chaveli C, Blázquez L, Marzo P, González G, de Miguel M, Abadía T y cols. Dolor crónico inguinal tras reparación herniaria. Análisis de nuestra serie a través de un cuestionario postal. Rev Hispanoam Hernia. 2013; 1: 5-11.

15. Neibuhr H, Wegner F, Hukauf M, Lechner M, Fortelny R, Bittner R et al. What are the influencing factors for chronic pain following TAPP inguinal hernia repair: an analysis of 20,004 patients from Herniamed Registry. Surg Endosc. 2017; 32: 1971-1983. doi: 10.1007/s00464-017-5893-2.

16. Losi P, Burchielli S, Spiller D, Finotti V, Kull S, Briganti E et al. Cyanoacrylate surgical glue as an alternative to suture threads for mesh fixation in hernia repair. J Surg Res. 2010; 163: e53-58.

17. Paajanen H, Kössi J, Silvasti S, Hulmi T, Hakala T. Randomized clinical trial of tissue glue versus absorbable sutures for mesh fixation in local anaesthetic Lichtenstein hernia repair. Br J Surg. 2011; 98: 1245-1251.

18. Shi Z, Fan X, Zhai S, Zhong X, Huang D. Fibrin glue versus staple for mesh fixation in laparoscopic transabdominal preperitoneal repair of inguinal hernia: a meta-analysis and systematic review. Surg Endosc. 2017; 31: 527-537.