scholarly journals A comparative study of Lichtenstein tension free hernioplasty with prolene hernia system hernioplasty for ingunial hernia

2019 ◽  
Vol 6 (10) ◽  
pp. 3581
Author(s):  
Shahaji Chavan ◽  
Harshad Gawade ◽  
Bhushan Shah ◽  
Akhil Kandarappa ◽  
Sunil Vishwanath Panchbha
Keyword(s):  
Hernia Repair ◽  
Hospital Stay ◽  
Recurrence Rate ◽  
Suitable Alternative ◽  
Tension Free ◽  
Myopectineal Orifice ◽  
Prolene Hernia System ◽  
Lichtenstein Hernia Repair ◽  
Significant Difference ◽  
Group Post

Background: Lichtenstein tension-free hernioplasty (LTH) has become the gold standard for hernia repair. It is easy to learn and perform with minimal complications and low recurrence rate. But it deals with only superior half of the myopectineal orifice. Prolene hernia system (PHS) hernioplasty is safe, causes minimal pain and has minimal recurrence rate but is still not popular due to high cost. The aim of the study is to compare the Lichtenstein tension-free hernioplasty with hernioplasty using prolene hernia system.Methods: A total of 60 patients with inguinal hernia were equally grouped into cases (PHS) and controls (LTH). Outcome measures were compared with regards to postoperative pain, hospital stay and complications.Results: There was no significant difference in mean days of post-operative hospital stay among cases and controls. On post-operative days 1 and 3, most of the patients experienced moderate pain and by 8th post-operative day most of the patients had no pain. The pain intensity decreased with increase in post-operative days. Seroma formation was seen among 2 (6.67%) cases (PHS) group in comparison to 3 (10.0%) controls (Lichtenstein) group. Post-operative wound infection was seen among 1 (3.33%) cases (PHS) group and controls (Lichtenstein) group each. Recurrence was seen neither among patients treated with either technique.Conclusions: Prolene Hernia System mesh repair could be a suitable alternative to time honored Lichtenstein hernia repair with added advantage of strengthening the whole of myopectineal orifice, and virtually eliminating any risk of recurrence. 

scholarly journals POST OPERATIVE WOUND INFECTION

2010 ◽  
Vol 17 (02) ◽  
pp. 174-179
Author(s):  
AAMIR IJAZ ◽  
SUHAIL AMER
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Prophylactic Antibiotics ◽  
Postoperative Wound Infection ◽  
Wound Infections ◽  
Postoperative Wound ◽  
Lichtenstein Hernia Repair ◽  
Significant Difference

Background: The use of antibiotic prophylaxis during Lichtenstein inguinal hernia surgery is controversial, and no definitive guidelines are available in literature. Objective: To determine effects of prophylactic antibiotics in reducing the frequency of postoperative wound infection in Lichtenstein hernia repair. Study Design: Case control study. Setting: Surgical Unit II, Allied Hospital, Faisalabad. Duration: One year, between January 2007 and December 2007. Methods: Patients undergoing unilateral, primary inguinal hernia repairelectively with the Lichtenstein technique using polypropylene mesh were randomized to receive 1.0 g intravenous Cefazolin before the incision or an equal volume of placebo. Wound infection was defined according to the criteria of Centers for Disease Control and recorded. Results were assessed using chi-square test. Results: 100 patients were included in the study. Minimum age of patients in this study was 20 and maximum 75 years with a mean of 44.06 in group A and 44.84 in group B. The total number of wound infections was 7 (7%); 2 (4%) in the antibiotic prophylaxis group and 5 (10%) in the placebo group. Statistical analysis showed no significant difference in the number of wound infections in both groups (p value=0.240). Conclusions: We conclude that in Lichtenstein inguinal hernia repair routine use of prophylactic antibiotics is not needed, as it does not significantly reduce the postoperative wound infection rates.

scholarly journals Conventional incision and drainage versus incision and drainage with primary closure in acute abscess: a prospective study

2017 ◽  
Vol 5 (1) ◽  
pp. 281
Author(s):  
Amandeep Singh ◽  
Gurdhian Singh ◽  
Darsshan Singh Sidhu ◽  
Mohit Bhalla
Keyword(s):  
Wound Healing ◽  
Hospital Stay ◽  
Recurrence Rate ◽  
Conventional Method ◽  
Primary Closure ◽  
The Body ◽  
P Value ◽  
Incision And Drainage ◽  
Significant Difference ◽  
A Prospective Study

Background: An abscess is a common surgical condition. Abscesses may occur anywhere in the body. Surgical treatment of subcutaneous and soft tissue abscesses includes percutaneous aspiration, incision and drainage without primary closure, incision and drainage with primary closure with drain. The present study was planned to compare conventional method of incision and drainage with incision and drainage with primary closure in cases of acute -abscesses.Methods: A total of 100 patients with acute abscesses were included in the study and randomized into 2 groups with 50 patients in each group. The present study was carried out to compare the conventional method of incision and drainage with incision and drainage with primary closure of the wounds in acute abscesses with regards to wound healing, post- operative pain, duration of hospital stays and recurrence rates.Results: Wound healing was significantly faster in incision and drainage with primary closure (9.18±0.941days) as compared to conventional method of incision and drainage (16.66±1.944 days) [p <0.05]. Mean hospital stay with convention method of incision and drainage was 7.12±0.718 days and with primary closure was 4.0±0.728days (p <0.05). Mean VAS was significantly less in primary closure as compared with conventional method. Decreasing trend in VAS was observed on day 3, day 5 and day 7 (p value 0.000). Recurrence rate of an abscess was seen in 5 cases in conventional method and 2 cases in primary closure (p >0.05).Conclusions: Author have observed a significant difference noted in time taken for wound healing, postoperative pain, hospital stay and recurrence rate between two groups.

scholarly journals Characteristics of predominantly right-sided colonic diverticulitis without need for colectomy

2020 ◽  
Author(s):  
Zhi Chen ◽  
Bing Zhang ◽  
Dan Wu ◽  
Ye Jin
Keyword(s):  
Hospital Stay ◽  
Recurrence Rate ◽  
Sigmoid Diverticulitis ◽  
Colonic Diverticulitis ◽  
Abdominal Drainage ◽  
Female Ratio ◽  
Uncomplicated Diverticulitis ◽  
Significant Difference ◽  
Male To Female ◽  
Acute Colonic Diverticulitis

Abstract Background: In China, diverticulitis is more often located in the right colon, mainly in the cecum and ascending colon. Here we study the characteristics of acute colonic diverticulitis and compare various treatments for acute right-sided colonic diverticulitis.Methods: A retrospective analysis of 123 patients with acute colonic diverticulitis treated in our hospital from April 2013 to April 2020, including 114 cases of right-sided colonic diverticulitis, was performed. The characteristics of acute colonic diverticulitis were analyzed, and the therapeutic effects of different treatments for acute right-sided colonic diverticulitis were compared.Results: 111 cases of caecal and ascending colonic diverticulitis were identified (90.2% of cases, male to female ratio 2.26:1, average age 39.6 ± 14.4 years, surgery ratio 24.3%, mean hospital stay 7.4 ± 4.3 days, recurrence rate 3.6%). Three cases of transverse colonic diverticulitis and three cases of descending colonic diverticulitis were found. Six cases of Sigmoid diverticulitis (4.9% of cases, male to female ratio 1:1, average age 67.7 ± 4.5 years, surgery ratio 33.3%, mean hospital stay 11.7 ± 5.5 days, recurrence rate 0%) were found. 13 patients underwent right-sided colonic diverticulitis resection and repair, while zero patients underwent colectomy. Abdominal drainage was performed in 15 patients with right-sided colonic diverticulitis. There was no significant difference in the length of hospital stay among the three treatments for right-sided colonic diverticulitis (P = 0.05). There was no significant difference in the recurrence rate among the three treatments of right-sided colonic diverticulitis ( P = 0.358). While the recurrence rate of right-sided colonic diverticulitis was only 3.5%, relapse usually occurred within the first year following treatment.Conclusions: In our patients, right-sided colonic diverticulitis is more common in young and middle-aged patients than in elderly patients and we see a higher incidence in males. Acute right-sided complex diverticulitis is rare. While non-surgical treatment is preferred for acute right-sided uncomplicated diverticulitis, no significant difference in outcome was observed between the three different treatments we compared. Resection and repair of diverticulum or abdominal drainage can also be used to treat patients with acute uncomplicated diverticulitis.

scholarly journals Desarda’s versus Lichtenstein technique of inguinal hernia repair

2017 ◽  
Vol 5 (1) ◽  
pp. 92
Author(s):  
Obaid Syed
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Complication Rate ◽  
Mesh Repair ◽  
Post Operative Pain ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
The Mean

Background: Ideal method for modern hernia surgery should be simple, cost effective, safe, tension free and permanent. The Lichtenstein operation to a great extent achieves this entire goal. The Lichtenstein mesh repair is associated with complications, postoperative dysfunction and high cost composite meshes. Desarda's technique, became a new surgical option for tissue-based inguinal hernia repair. The present study was designed to evaluate and compare the effectiveness and complications of the Desarda’s repair with Lichtenstein tension-free mesh repair for treatment of inguinal hernia in a developing country.Methods: 200 patients with unilateral, primary, reducible inguinal hernia were selected. Included patients were randomly divided into two groups. Studied parameters were Duration of surgery, intra operative complications, post-operative Pain, Duration of hospital stay, return to normal activities, post-operative complications and recurrences.Results: There were a total of 100 patients each group. There was no statistically significant difference in duration of surgery and complication rate between the two groups. Difference in mean VAS was not statistically significant. The mean hospital stay in Desarda’s technique was 2.5 days while it was 2.6 days in Lichtenstein’s group. The mean time to return to basic physical activity in the Desarda’s technique was 12.6 days while it was 13.3 days in the Lichtenstein’s group. There were no recurrences in either group. Chronic inguinal pain (>1month) was more frequent in Lichtenstein’s group.Conclusions: There is no significant difference in duration of surgery, intra operative complication rate, post-operative pain, complications and recurrence, between Desarda’s technique and Lichtenstein’s technique. However chronic inguinal pain is less in Desarda’s technique. Desarda’s repair must be considered in young patients (<30 years). Its long-term efficacy needs to be studied with larger, prospective double-blind randomized trials, with longer follow-up.

scholarly journals Prolene Hernia System Herniorraphy Versus Open Inguinal Hernia Repair by Lichtenstein Tension Free Mesh Hernioplasty -A Randomized Study

2020 ◽  
Vol 5 (8) ◽  
pp. 729-733
Author(s):  
Dr. Kunal Malhotra ◽  
Dr. Tushar Aggarwal ◽  
Dr. Subhash Sharma ◽  
Dr. Anil Malhotra
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Randomized Study ◽  
Tension Free ◽  
Prolene Hernia System ◽  
Operative Complications ◽  
Open Inguinal Hernia Repair ◽  
Mesh Hernioplasty

Prolene Hernia System is a tension free anterior inguinal hernia repair using a bilayered modification of inguinal hernia mesh. Inguinal hernia repair by Prolene is comparable with almost equal operating time, smaller incision and with a trend towards decreased complications rate and reduced rate of recurrences. This study was conducted to study and to compare the results of Prolene Hernia System and Lichtenstein Tension Free mesh hernioplasty with respect to its operative time, post-operative pain, intra/post-operative complications and total hospital stay. The effectiveness of PHS were compared to Lichtenstein tension free mesh hernias repair in patients presenting with uncomplicated Inguinal Hernia for elective surgery in the Surgery department of IGMC, Shimla. Duration of surgery was shorter in Prolene Hernia System group (p=0.04) than the Lichtenstein tension free mesh hernioplasty [32 vs 34 minutes], The mean pain intensity in present study was 2.9 in Lichtenstein tension free mesh hernioplasty group and 2.7 in Prolene Hernia System, No intra-operative complications were seen with either of the two groups. Post-operative complications in the form of Seroma formation were more in Lichtenstein tension free mesh hernioplasty group than Prolene Hernia System group (8 vs 0). There were two cases of recurrence in the Lichtenstein tension free mesh hernioplasty group, while no short-term recurrence was seen in Prolene Hernia System group over 12 weeks. Mean duration of post-operative hospital stay was 1.57 days for Lichtenstein tension free mesh hernioplasty group and 1.33 days for Prolene Hernia System group. This study concludes that even though the difference between the two methods in this randomized study were small, the Prolene Hernia System repair method for open inguinal hernia repair was associated with a shorter operative time, lower rate of recurrence, as well as fewer complications when compared with the Lichtenstein tension free mesh hernioplasty. Further prospective studies are needed to rigorously evaluate the comparative advantages of Prolene Hernia System repair in relation to other repair methods

A COMPARITIVE STUDY OF ONLAY – SUBLAY MESHPLASTY (PHS) vs. LICHTENSTEIN MESHPLASTY OF INGUINAL HERNIA

2021 ◽  
pp. 56-58
Author(s):  
Chenna Dharma Kishore Raja ◽  
Sreerama Raja
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Return To Work ◽  
Hospital Stay ◽  
Mesh Repair ◽  
Age Distribution ◽  
P Value ◽  
Tension Free ◽  
Duration Of Surgery ◽  
Type Of Surgery

Introduction: A Hernia is the protrusion of part of the abdominal contents beyond the abdominal wall's normal connes. In this study, an attempt is made to compare the results of two different modalities of hernia repair–Lichtenstein repair and repair of hernia with Polypropylene hernia system. Aim: The study aims to ascertain the Polypropylene hernia system's safety and benets for hernia repair against conventional Lichtenstein tension-free mesh repair technique. Materials and methods: The prospective clinical study comprises 30 patients presenting with inguinal hernia attending OPD and admitted to the General Surgery Department of King George Hospital, Visakhapatnam, during the study period of September 2018 to October 2020. Results: Age distribution between 10-90, most of the 50-70 age group (14 cases). Visual analog scale (VAS) score for PMR 4.55 ± 1.18 and LMR 6.06 1.27 (p-value <0.05). Wound infection for PMR 1 case and LMR 2 cases. Duration of surgery for PMR 65.40 ± 7.84 and LMR 51.33 ± 13.51 (p-value <0.05). Type of surgery and duration of hospital stay for PMR 4.93 ± 1.27 LMR 6.73 ± 2.12. Type of surgery and return to work for PMR 5.93 ± 1.27 and LMR 7.73 ± 2.12(p-value <0.05).Recurrence in PMR 0 % and LMR 6.67%. Conclusion: PHS repair is superior to Lichtenstein mesh repair about safe, tension-free method, shorter hospital Stay, early return to work, least recurrence rates, and a high subjective success rate and satisfaction rate.

scholarly journals Inguinal hernia repair – TEP or TAPP?? A comparative analysis between both the laparoscopic procedures in a tertiary care center

2020 ◽  
Vol 11 (6) ◽  
pp. 84-88
Author(s):  
Atia Zaka Ur Rab ◽  
Sheikh Saif Alim ◽  
Wasif Mohammad Ali ◽  
Syed Amjad Ali Rizvi
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Prospective Study ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Normal Work

Background: Inguinal hernia surgery is one of the most common elective procedures performed by the surgeons and has evolved from open to the laparoscopic technique. Aims and Objectives: This prospective study was conducted to find out intra-operative and post-operative outcomes in patients undergoing TEP and TAPP for inguinal hernia repair. Materials and Methods: A prospective study was conducted on 50 adult patients who underwent laparoscopic inguinal hernia repair between November 2017 to November 2018. It was a randomized study and equal number of patients were allocated to TAPP and TEP group based on the surgeon’s preference. Results: Operative time [p<0.0001], intensity of pain (VAS) was significantly higher in TAPP compared to TEP in the immediate post-operative period (6 hours) and during hospital stay [p=0.0299]. No significant difference observed in VAS between TEP and TAPP during follow up [after 1 week (p=0.2298), 2 weeks (p=0.2337), and 4 weeks (p=0.3944)]. Both TEP and TAPP were comparable in terms of Intra-operative and Post-operative complications {seroma [during hospital stay (p=0.1573), after 1 week (p=0.6375), after 2 weeks (p=0.5513)]; haematoma [during hospital stay (p=0.1492), after 1 week (p=0.3125)]} and Conversion (p=0.3125), and Length of hospital stay (p=0.3960). Time to resume normal work [p<0.0001] was significantly more in TAPP than TEP. Conclusion: TEP has a definite edge over TAPP taking into consideration the lesser intensity of post-operative pain during hospital stay, shorter duration of surgery and relatively early return to normal work associated with the former procedure. TEP should therefore be regarded as the procedure of choice for inguinal hernia repair.

scholarly journals Comparative analysis of autodermal graft and polypropylene mesh use in large incisional hernia defects reconstruction

2013 ◽  
Vol 70 (2) ◽  
pp. 182-188 ◽  
Author(s):  
Danilo Stojiljkovic ◽  
Predrag Kovacevic ◽  
Milan Visnjic ◽  
Irena Jankovic ◽  
Goran Stevanovic ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Hospital Stay ◽  
Abdominal Wall ◽  
Polypropylene Mesh ◽  
Synthetic Mesh ◽  
Abdominal Wall Defects ◽  
Tension Free ◽  
Large Incisional Hernia ◽  
Significant Difference ◽  
Duration Of Surgery

Background. Large defects of the abdominal wall caused by incisional hernia still represent a challenging problem in plastic, reconstructive, and abdominal surgery. For their successful tension-free repair a proper selection of reconstructive material is essential. In the last decades, the use of synthetic meshes was dominant while biological autodermal grafts were rarely used. The aim of the study was to comparatively analyse efficacy and safety of autodermal graft and polypropylene mesh in surgical treatment of large abdominal wall defects. Methods. This prospective comparative clinical study enroled 40 patients surgically treated for large incisional hernia repair in a 10-year period. The patients were divided into two equal groups consisting of 20 subjects and treated either by biological autodermal graft or by synthetic polypropylene mesh. The surgical techniques of reconstruction, duration of surgery, the occurrence of early, minor, and major (severe) and delyed complications and hospital stay were analyzed. The average follow-up took 2 years. Results. Statistically significant differences in demographic characteristics of patients and in size of defects were not found. The surgical technique of reconstruction with an autodermal graft was more complicated. The duration of surgery in patients treated with autodermal grafts was significantly longer. There was no statistically significant difference regarding occurrence of early, minor postoperative complications and hospital stay in our study. Two severe complications were registered in the synthetic mesh group: intestinal obstruction and enterocutaneous fistula. The recurrence rate was 10% in the autodermal graft group and 15% in the group with a synthetic mesh. Conclusion. Tension-free repair of large incisional hernia with autodermal grafts was unjustly neglected despite the fact that it is safe and effective. It can be applied in all cases where synthetic mesh are not indicated (presence of infection, immunodeficient patients, after radiotherapy). They are especially important in war surgery and in lack of funds when commercial grafts cannot be purchased.

scholarly journals Prospective Randomized Blinded Study to Compare Laparoscopic and Open Inguinal Hernioplasty

2020 ◽  
Vol 3 (1) ◽  
pp. 149-154
Author(s):  
Mohd. Ilyas ◽  
Venkat Vaijnath Cholleti
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Randomized Study ◽  
Early Assessment ◽  
Post Operative Pain ◽  
Number Of Patients ◽  
Study Results ◽  
Significant Difference

Background: Hernia is one of the common surgical problems. Repair of inguinal hernia is one of the commonest surgical procedures worldwide, irrespective of country, race or socio-economic status and constitutes a major health-care in every country. Subjects and Methods: This is a randomised prospective study done over 50 patients in the department of general surgery of Kamineni hospitals, LB Nagar, Hyderabad during the period of October 2010 to August 2012 with the aim to compare laproscopic inguinal hernia repair and open inguinal hernia repair with regards to post-operative pain, surgical site infections, hospital stay and time taken to return to work, by a randomized study. Results: Compare laparoscopic and mesh inguinal hernia repairs, there is no significant difference in early assessment with regards to duration of operation, post-operative pain, analgesic requirements on the day of surgery and first post-operative day, hospital stay, return to daily and normal activities and post-operative complications. Conclusion: Laparoscopic mesh hernioplasty still remains to be validated with larger number of patients and longer duration of follow up.

Mechanical versus Chemical Pleurodesis after Bullectomy for Primary Spontaneous Pneumothorax: A Systemic Review and Meta-Analysis

2019 ◽  
Vol 30 (06) ◽  
pp. 490-496 ◽  
Author(s):  
Sarah Kher Ru Sim ◽  
Shireen Anne Nah ◽  
Amos Hong Pheng Loh ◽  
Lin Yin Ong ◽  
Yong Chen
Keyword(s):  
Hospital Stay ◽  
Recurrence Rate ◽  
Spontaneous Pneumothorax ◽  
Meta Analysis ◽  
Primary Spontaneous Pneumothorax ◽  
Systemic Review ◽  
High Recurrence Rate ◽  
Chemical Pleurodesis ◽  
Significant Difference ◽  
Observational Cohort

Abstract Introduction Primary spontaneous pneumothorax (PSP) and its high recurrence rate pose a therapeutic challenge to both patients and their managing surgeons. Mechanical or chemical pleurodesis can be used to prevent recurrence, but the optimal treatment often remains a matter of debate. This meta-analysis aims to compare the outcomes between mechanical and chemical pleurodesis following bullectomy for PSP. Materials and Methods Studies published up to 2019 were searched from Medline, Embase, Google Scholar, and Cochrane databases. A meta-analysis of randomized controlled trials (RCTs) and observational cohort studies (OCSs) comparing outcomes between mechanical and chemical pleurodesis for PSP was performed. Results Seven studies (one RCT and six OCSs) were included, comprising 1,032 cases of mechanical (799 abrasions, 202 pleurectomies, and 31 unspecified abrasions/pleurectomies/both), and 901 cases of chemical (643 talc, 69 minocycline, and 189 unspecified talc/kaolin) pleurodesis. The recurrence rate of pneumothorax after chemical pleurodesis (1.2%) was significantly lower than mechanical pleurodesis (4.0%) (pooled odds ratio [OR] = 3.00; 95% confidence interval [CI] = 1.59–5.67; p = 0.0007; I 2 = 19%). Hospital stay was also slightly shorter in the chemical pleurodesis group (pooled mean difference [MD] = 0.42 days; 95% CI = 0.12–0.72; p = 0.005; I 2 = 0%). There was no statistically significant difference in postoperative complications (pooled OR = 1.18; 95%CI = 0.40–3.48; p = 0.76; I 2 = 71%) and operative time (pooled MD = 3.50; 95%CI = −7.28 to 14.28; p = 0.52; I 2 = 99%) between these two groups. Conclusion Chemical pleurodesis is superior to mechanical pleurodesis following bullectomy for PSP in reducing hospital stay and recurrence rate. However, more RCTs with longer follow-up are necessary to demonstrate the benefit of chemical pleurodesis for PSP.

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