Hernia : the journal of hernias and abdominal wall surgery
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Randomized Controlled Trial Comparative Study
Prospective randomized trial comparing sutured with sutureless mesh fixation for Lichtenstein hernia repair: long-term results.
Following Lichtenstein hernia repair, up to 25% of patients experience prolonged postoperative and chronic pain as well as discomfort in the groin. One of the underlying causes of these complaints are the compression or irritation of nerves by the sutures used to fixate the mesh. We compared the level and rate of chronic pain in patients operated with the classical Lichtenstein technique fixated by sutures to patients with sutureless mesh fixation technique. ⋯ After 5 years, the two techniques of mesh fixation resulted in similar rates of chronic pain. Whereas recurrence rates were comparable, fixation of the mesh with tissue glue decreased operating room time significantly. Hence, suture less mesh fixation with Histoacryl is a sensible alternative to suture fixation and should be especially considered for patients prone to pain.
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Randomized Controlled Trial Comparative Study
Comparison of ultrasonography and physical examination in the diagnosis of incisional hernia in a prospective study.
Incisional hernia is a frequent complication of abdominal surgery (incidence 2-20%). Diagnosis by physical examination is sometimes difficult, especially in small incisional hernias or in obese patients. The additional diagnostic value of standardized ultrasonography was evaluated in this prospective study. ⋯ There are no clear diagnostic criteria for incisional hernia available in the literature. Standardized combination of ultrasonography with physical examination during follow-up yields a significant number of, mostly asymptomatic, hernias, which would not be found using physical examination alone. This is especially relevant in research settings.
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Long-term quality of life after hernioplasty using a Prolene hernia system in adult inguinal hernia.
Most surgeons favour the use of a mesh for open inguinal hernia repair as it has a low recurrence rate. Procedures used most frequently are the Lichtenstein method, mesh plug repair and the Prolene hernia system (PHS). The choice of technique may be influenced by effects on postoperative pain and quality of life. In this retrospective study, results from inguinal hernia repair with the PHS in a regional training hospital were analysed. ⋯ In a regional training hospital, primary inguinal hernias were treated with low recurrence and few complications by use of the PHS.