Inguinal hernia repair with beta glucan-coated mesh: Prospective multicenter study (115 cases) - Preliminary results

被引:16
作者
Barrat C. [1 ]
Seriser F. [2 ]
Arnoud R. [3 ]
Trouette P. [4 ]
Champault G. [1 ]
机构
[1] Department of Digestive Surgery, CHU J. Verdier, 93140 Bondy
[2] CHP St. Martin, Caen
[3] Clinique du Tondo, Bordeaux
[4] Clinique de l'Union, L'Union
关键词
Beta glucan; Inguinal hernia; Prosthesis; Quality of life;
D O I
10.1007/s10029-003-0156-7
中图分类号
学科分类号
摘要
Prosthetic reinforcement is now routine in the management of inguinal hernia, and it significantly reduces the risk of recurrence. However, there may be postoperative pain and discomfort of late onset, the intensity of which appears to be related to the rigidity of the material and its ability to integrate with tissues. We have evaluated the results of implantation with beta glucan-coated polypropylene mesh both objectively (early recurrence) and functionally (pain and quality of life). The mass of the coated mesh is reduced by 50% compared to a typical polypropylene implant. Beta glucan is an entirely natural plant product that eliminates the risk of viral or prion contamination associated with the use of collagen of animal origin. One hundred fifteen patients with a mean age of 55 years with a primary or recurrent inguinal hernia were treated with a prosthesis (Glucamesh). Fifty-eight patients underwent a Lichtenstein procedure, and 57 had a laparoscopic procedure (TEP, TAPP). Mean operative time was 40 min. There was no mortality, and morbidity was 8.6%. At 3 months follow-up, no recurrences were observed. The characteristics of the prosthesis were considered to be good or excellent in 93.9-100% of cases. Residual postoperative pain (analogue pain score less than 2) occurred in 4.3% of cases at day 15 and in 2.7% at day 90. The quality-of-life health score of the SF36 questionnaire preoperatively and postoperatively showed a significant improvement (P<0.05) in the scores and a quality of life equivalent to healthy control subjects. This prosthesis is associated with a rapid and significant resolution of postoperative pain and a quick return to normal activity with an improved quality of life. In addition, the plant origin of the prosthesis eliminates any risk of viral or prion contamination. © Springer-Verlag 2003.
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页码:33 / 38
页数:5
相关论文
共 30 条
[1]  
Oberlin P., Faut-il opérer toutes les hernies de l'aine?, Ann. Chir., 27, pp. 161-163, (2002)
[2]  
Barrat C., Surlin V., Catheline J.M., Rizk N., Champault G., Evolution des techniques de cure de hernie inguinale au cours de la dernière décennie. A propos de 1000 cas, J. Coelio Chir., (2003)
[3]  
Mesh compared with non mesh methods of open groin hernia repair. Systematic review of randomized controlled trial, Br. J. Surg., 87, pp. 854-859, (2000)
[4]  
Amid P.K., Lichtenstein I.L., Long-term result and current status of the Lichtenstein open tension-free hernioplasty, Hernia, 2, pp. 89-94, (1998)
[5]  
Hernandez-Granados P., Ontanon M., Garcia C., Arguello M., Medina I., Tension-free hernioplasty in primary inguinal hernia. A series of 2,054 cases, Hernia, 4, pp. 141-143, (2000)
[6]  
Sebbag H., Brunaud L., Collinet-Adler S., Ulmer M., Marchal F., Grosdidier G., Long-term follow-up of totally extraperitoneal laparoscopic treatment of inguinal hernia at a single center, Hernia, 4, pp. 292-295, (2000)
[7]  
Benchetrit S., Debaert M., Detruit B., Dufilho A., Gaujoux D., Lagoutte J., Lepere M., Martin Saint Leon L., Pavis d'Escurac X., Rico E., Sorrentino J., Therin M., Laparoscopic and open abdominal wall reconstruction using Parietex meshes. Clinical results in 2,700 hernias, Hernia, 2, pp. 57-62, (1998)
[8]  
Barrat C., Surlin V., Bordea A., Champault G., Management of recurrent inguinal hernia. A prospective study of 163 cases, Hernia, (2003)
[9]  
Ware J.E., Scherbourne C.D., The MOS 36-item short-form health survey (SF36), Med. Care, 30, pp. 473-483, (1992)
[10]  
Lawrence K., Jenkinson C., Mc Whinnie D., Coulter A., Quality of life in patients undergoing inguinal hernia repair, Ann. R. Coll. Surg. Engl., 79, pp. 40-45, (1997)