M Matikainen1,2,3, J Kössi4, S Silvasti5, T Hulmi5, H Paajanen6,7. 1. Department of Surgery, Kuopio University Hospital, Kuopio, Finland. markku.matikainen@pkssk.fi. 2. School of Medicine, University of Eastern Finland, Kuopio, Finland. markku.matikainen@pkssk.fi. 3. Department of Surgery, North Karelia Central Hospital, Joensuu, Finland. markku.matikainen@pkssk.fi. 4. Department of Surgery, Paijat-Hame Central Hospital, Lahti, Finland. 5. Department of Surgery, North Karelia Central Hospital, Joensuu, Finland. 6. Department of Surgery, Kuopio University Hospital, Kuopio, Finland. 7. Department of Surgery, Mikkeli Central Hospital, Mikkeli, Finland.
Abstract
BACKGROUND: Lichtenstein hernioplasty has relatively low recurrence rate, but chronic inguinal pain may cause harm to the patient. The aim of our study was to compare long-term results of cyanoacrylate glue versus absorbable sutures for mesh fixation in Lichtenstein hernioplasty. METHODS:Lichtenstein hernioplasty (n = 302) was performed under local anesthesia in three hospitals. The patients were randomized to receive either 1 ml of butyl-2-cyanoacrylate tissue glue (Glubran®; 151 hernias) or absorbable polyglycolic acid sutures (Dexon®; 151 hernias) for mesh fixation (Optilene® mesh). Short-term results were published previously. Chronic groin pain, foreign body sensation, use of analgesics, recurrence and re-operations were analyzed 7 years after surgery. RESULTS: We reached 236 patients (78%) to present study. In the glue group (n = 115), there were five (4.3%) and in the suture group (n = 121) three (2.5%) recurrent hernias (p = 0.491). The prevalence of chronic pain (NRS ≥ 3) in the patients without re-operations was similar in two groups: 15/118 (13%) and 13/111 (12%), respectively (p = 0.843). There were no significant differences in the foreign body sensation (8/14, p = 0.267) or in the need of analgesics (2/2, p = 1.00) between the two study groups. CONCLUSION: Both cyanoacrylate glue and mesh fixation with absorbable sutures were equal in terms of chronic pain and rate of recurrences in Lichtenstein hernioplasty after 7-year follow-up. TRIAL REGISTRATION NUMBER: NCT00659542.
RCT Entities:
BACKGROUND:Lichtenstein hernioplasty has relatively low recurrence rate, but chronic inguinal pain may cause harm to the patient. The aim of our study was to compare long-term results of cyanoacrylate glue versus absorbable sutures for mesh fixation in Lichtenstein hernioplasty. METHODS:Lichtenstein hernioplasty (n = 302) was performed under local anesthesia in three hospitals. The patients were randomized to receive either 1 ml of butyl-2-cyanoacrylate tissue glue (Glubran®; 151 hernias) or absorbable polyglycolic acid sutures (Dexon®; 151 hernias) for mesh fixation (Optilene® mesh). Short-term results were published previously. Chronic groin pain, foreign body sensation, use of analgesics, recurrence and re-operations were analyzed 7 years after surgery. RESULTS: We reached 236 patients (78%) to present study. In the glue group (n = 115), there were five (4.3%) and in the suture group (n = 121) three (2.5%) recurrent hernias (p = 0.491). The prevalence of chronic pain (NRS ≥ 3) in the patients without re-operations was similar in two groups: 15/118 (13%) and 13/111 (12%), respectively (p = 0.843). There were no significant differences in the foreign body sensation (8/14, p = 0.267) or in the need of analgesics (2/2, p = 1.00) between the two study groups. CONCLUSION: Both cyanoacrylate glue and mesh fixation with absorbable sutures were equal in terms of chronic pain and rate of recurrences in Lichtenstein hernioplasty after 7-year follow-up. TRIAL REGISTRATION NUMBER: NCT00659542.
Authors: S Canonico; A Santoriello; F Campitiello; A Fattopace; A Della Corte; I Sordelli; R Benevento Journal: Hernia Date: 2005-08-17 Impact factor: 4.739
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Authors: U Bracale; M Rovani; A Picardo; G Merola; G Pignata; M Sodo; E Di Salvo; E L Ratto; A Noceti; P Melillo; L Pecchia Journal: Hernia Date: 2012-11-20 Impact factor: 4.739