Systemic inflammatory response after Kugel versus laparoscopic groin hernia repair: a prospective randomized trial
Systemic inflammatory response after Kugel versus laparoscopic groin hernia repair: a prospective randomized trial
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DOI：
10.1007/s00464-009-0495-2
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发表时间：
2009-12-01
影响因子：
3.1
通讯作者：
Sari, Yavuz Selim
中科院分区：
文献类型：
--
作者：
Bender, Oemer;Balci, Fatih Levent;Sari, Yavuz Selim
Kugel修补术是一种微创技术，已成为腹腔镜腹股沟疝修补术的替代方法，但该技术尚未通过评估客观参数进行充分评价。为比较采用Kugel和完全腹膜外（TEP）腹腔镜方法行腹股沟疝修补术的患者对手术创伤的全身炎症反应和临床结局，进行了一项前瞻性随机临床研究，40例单侧腹股沟疝患者在全麻下随机接受Kugel（n = 20）或TEP（n = 20）修补术。比较手术时间、住院时间、疼痛严重程度、恢复正常活动时间、费用、手术创伤引起的全身炎症反应和激素反应，两组在手术时间、住院时间、恢复正常活动时间或平均视觉模拟量表（VAS）评分方面均无显著差异（p > 0.05）。两组术前、术后1 h和术后24 h的血清皮质醇、高敏C反应蛋白（hsCRP）和白细胞介素（IL）-6浓度无显著差异（p > 0.05）。随访期间无复发及并发症。Kugel疝修补术是一种微创技术，具有TEP的所有优点，更具成本效益。
Kugel repair, a minimally invasive technique, has become an alternative to laparoscopic groin hernia repair, but the technique has not been adequately evaluated by assessment of objective parameters. A prospective randomized clinical study was carried out to compare the systemic inflammatory response to surgical trauma and clinical outcomes in patients who underwent groin hernia repair by the Kugel and totally extraperitoneal (TEP) laparoscopic methods.Forty consecutive patients admitted for unilateral groin hernia were randomized to Kugel (n = 20) or TEP (n = 20) repair under general anesthesia. Operation time, length of hospital stay, pain severity, time to return to normal activities, cost, and systemic inflammatory and hormone responses to surgical trauma were compared.There were no significant between-group differences in duration of operation, length of hospital stay, time to return to normal activities, or mean visual analogue scale (VAS) score (p > 0.05 for each). Serum cortisol, high-sensitivity C-reactive protein (hsCRP), and interleukin (IL)-6 concentrations before surgery, and 1 and 24 h after surgery, did not differ significantly in the two groups (p > 0.05). There were no recurrences or complications during follow-up. Cost per patient was US $546 lower in the Kugel group.Kugel herniorrhaphy is a minimally invasive technique that offers all the advantages of TEP and is more cost-effective.