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Title of Journal: Hernia

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Abbravation: Hernia

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Springer-Verlag

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DOI

10.1016/0005-7967(70)90054-9

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1248-9204

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Oneyear results of a prospective randomised clin

Authors: R Bittner B J Leibl B Kraft J Schwarz
Publish Date: 2011/04/03
Volume: 15, Issue: 5, Pages: 503-510
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Abstract

A low rate of chronic pain and maximum postoperative comfort are the main goals today in inguinal hernia repair This fourarm randomised trial compares these parameters after laparoscopic hernia repair TAPP with a standard heavyweight mesh HW a pure middleweight polypropylene mesh MW a lightweight composite polypropylene mesh LW or a titanised lightweight mesh TLW The primary endpoint of the study was the incidence of chronic pain of any severity at the site of hernia repair at 1 yearA total of 600 patients with a laparoscopic inguinal hernia repair and a defect diameter of 3–5 cm were included in the trial In all patients a noninvasive mesh fixation technique was performed using fibrin glue Patients were assessed for pain foreign body sensation and physical activities preoperatively early postoperatively at 4 weeks at 6 months and at 1 year by questionnaire and were examined clinically Postoperatively seroma formation was measured by ultrasoundAt 1 year after TAPP frequency of pain did not differ statistically between the four groups depending on type of activity between 6–8 with HW mesh 2–4 with middleweight mesh and 2–47 with both lightweight meshes average intensity of pain was very low at between VAS 04 ± 31 and 15 ± 78 MW LW TLW and between 19 ± 86 and 23 ± 91 HW depending on activity ns Early postoperatively between 313 LW and 213 TLW of the patients needed pain medication ns at 1 year this percentage had dropped to 03 one HW one MW Foreign body sensation did not differ but impairment of physical activities P = 00437 was significantly less in the MW LW and TLW group 6–127 compared to HW 153 at 4 weeks at 1 year this percentage was between 0 and 13 nsCompared to HW mesh the use of MW LW and TLW meshes for laparoscopic hernia repair did not significantly affect rate of chronic pain but seemed to improve early postoperative convalescence No difference was found between middleweight pure polypropylene MW composite lightweight LW or titanised lightweight polypropylene TLW meshesThe authors thank PD Dr S Sauerland MD MPH Institute for Research in Operative Medicine IFOM University of Witten/Herdecke Cologne Germany for his assistance in planning the study and in the calculation of the number of the study population and Mr U Schmidt StatConsult Gesellschaft für Klinische und Versorgungsforschung mbH Magdeburg for statistical analyses


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Other Papers In This Journal:

  1. Classification of groin hernia: Milestones
  2. Modified laparoscopic intraperitoneal onlay mesh in complicated inguinal hernia surgery
  3. A comparison of Progrip ® and Adhesix ® self-adhering hernia meshes in an onlay model in the rat
  4. Comparison of Permacol™ and Strattice™ for the repair of abdominal wall defects
  5. Archaic terms and dogmas impeding care of abdominal and pelvic herniation
  6. Laparoscopic management of urachal cyst associated with umbilical hernia
  7. Inguinal hernia is a common complication in lower midline incision surgery
  8. Incisional hernia in patients at risk: can it be prevented?
  9. Groin hernia repair in young males: mesh or sutured repair?
  10. Two-port totally extraperitoneal inguinal hernia repair: a 10-year experience
  11. Use of dynamic wound closure system in conjunction with vacuum-assisted closure therapy in delayed closure of open abdomen
  12. Relationship between body mass index and the incidence of inguinal hernia repairs: a population-based study in Olmsted County, MN
  13. An enigma of spontaneous combined transdiaphragmatic, intercostal and abdominal wall hernia
  14. De Garengeot’s hernia: the importance of early diagnosis and its complications
  15. Late bilateral diaphragmatic rupture: Challenging diagnostic and surgical repair
  16. Genetic analysis of the TBX2 gene promoter in indirect inguinal hernia
  17. Prognostic value of age for chronic postoperative inguinal pain
  18. Operation Hernia to Ghana
  19. Schley’s inguinal hernia repair: a single unit’s experience of a forgotten technique
  20. Commentary on: low-cost mesh for inguinal hernia repair in resource-limited settings
  21. Incisional pubic hernia: treatment of a case with congenital malformation of the pelvis
  22. Proper mesh overlap is a key determinant in hernia recurrence following laparoscopic ventral and incisional hernia repair
  23. Laparoscopic versus open groin hernia repair: meta-analysis of randomised trials based on individual patient data
  24. An evaluation of hernia education in surgical residency programs
  25. Irreducible inguinal hernia due to crossed testicular ectopia in an infant
  26. New Editor-in-Chief
  27. New Editor-in-Chief
  28. Intraperitoneal tension-free repair of small midline ventral abdominal wall hernias with a Ventralex hernia patch: initial experience in 51 patients
  29. Tissue expanders: early experience of a novel treatment option for perineal herniation
  30. What happens to the rectus abdominus fascia after laparoscopic ventral hernia repair?
  31. Abdominoscrotal hydrocele in a 9-month old infant
  32. Creation of a novel risk score for surgical site infection and occurrence after ventral hernia repair
  33. Are there any predictive factors of metachronous inguinal hernias in children with unilateral inguinal hernia?
  34. Letter to the editor
  35. Watchful waiting as a treatment strategy for patients with a ventral hernia appears to be safe
  36. Use of porcine dermal collagen graft (Permacol) for hernia repair in contaminated fields
  37. Epigastric hernia and its etiology
  38. Quality of life and outcomes for femoral hernia repair: does laparoscopy have an advantage?
  39. Evaluation of crosslinked and non-crosslinked biologic prostheses for abdominal hernia repair

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