Authors: E Boldo
Publish Date: 2007/10/18
Volume: 22, Issue: 5, Pages: 1206-1209
Abstract
The use of fibrin for mesh fixation in laparascopic hernioplasty has theoretical advantages in that it could result in reducing postoperative pain The objective of this study is to demonstrate this improvement in postoperative pain with the highest level of evidence possibleUnicenter single surgeon prospective randomized doubleblind study of transabdominal preperitoneal TAPP bilateral hernioplasties comparing autologous fibrin sealant FG used for mesh fixation on one side and staples SG on the other Data were collected regarding anthropometric measures costs complications and pain evaluation at postoperative days 7 30 and 180 using a visual analogue scale The patients were also asked to answer the following simple question “On which side do you have more pain”Twentytwo eligible patients were included in the study Both groups were comparable The operating time was significantly longer 30 min more in the FG The incidence of seroma was similar in both groups and that of hematoma was higher in the SG 0 vs 91 At 1 week the visual analogue scale scores were significantly lower in the FG median 17 vs 45 MWU1035 p 005 At 1 month this difference became clinical and statistically insignificant 727 of the patients referred more pain on the side with staples at 1 week 38 at 1 month and 0 at 6 months after patients with hernia recurrence were excluded The recurrence rate was higher in the FG 99 vs 136 A hernia in the FG cost 200 Euros more than that in the SG or even more if a complete economic study is consideredThe use of fibrin produces less postoperative pain in the first week but prolongs operating time and increases costs Moreover there appears to be a higher recurrence rate and a lower incidence of hematoma while the incidence of seroma remains unchangedThe authors are grateful to the Fundacion de la Comunidad Valenciana Hospital Provincial de Castellon the public foundation for promoting investigation in health sciences of the Consorcio Hospitalario Provincial de Castellon for technical and financial support Dr Perez de Lucia the surgeon in charge of collecting the postoperative evaluation has no personal or financial relationship with the MBA company distributor of Vivostat in Spain Dr Boldo was invited to present this early result as a nonprofit CME activity conference organized by the MBA company for Spanish surgeons
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