Abstract | OBJECTIVE: The aim of this study was to compare the morbidity of fixation of prosthetic meshes using Tissucol fibrin glue versus staples in laparoscopic transabdominal preperitoneal ( TAPP) repair of inguinal and femoral hernias. SUMMARY BACKGROUND DATA: METHODS: Between June 2003 and February 2005, 197 patients with inguinal or femoral hernia were enrolled in this prospective, randomized study, to assess morbidity following hernia repair with staples (n = 98) or Tissucol (n = 99). The primary outcomes were early postoperative and late neuralgia recorded using a visual analog scale (VAS). The effects of neuralgia on functional status were evaluated using the modified SF-36 questionnaire. Secondary outcomes included complications such as nonspecific pain and recurrence. RESULTS: Assessments took place at 1, 3, 6, and 12 months, with all patients completing each follow-up visit. Mean VAS scores were significantly lower in the Tissucol group versus the staples group (MANOVA, P < 0.05). Higher scores for the modified SF-36 questionnaire at 1 month were demonstrated in the Tissucol group compared with the staples group (23.2 and 22.6, respectively; P < 0.05). The mean recovery time for normal physical activity was significantly shorter in the Tissucol group compared with the staples group (7.9 vs. 9.1 day, respectively; P < 0.001). One recurrence was seen in the fibrin glue group, which was attributable to a technical error in fixation of the mesh. CONCLUSIONS: The use of Tissucol provides distinct advantages in laparoscopic treatment of inguinal/ femoral hernias compared with conventional TAPP, including a lower incidence of postoperative neuralgia and an earlier resumption of physical and social activities.
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Authors | Federico Lovisetto, Sandro Zonta, Emanuela Rota, Massimiliano Mazzilli, Marco Bardone, Luca Bottero, Giuseppe Faillace, Mauro Longoni |
Journal | Annals of surgery
(Ann Surg)
Vol. 245
Issue 2
Pg. 222-31
(Feb 2007)
ISSN: 0003-4932 [Print] United States |
PMID | 17245175
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Fibrin Tissue Adhesive
- Tissue Adhesives
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Topics |
- Adolescent
- Adult
- Aged
- Female
- Fibrin Tissue Adhesive
(pharmacology)
- Follow-Up Studies
- Hernia, Femoral
(surgery)
- Hernia, Inguinal
(surgery)
- Humans
- Laparoscopy
- Male
- Middle Aged
- Peritoneum
(surgery)
- Prospective Studies
- Prosthesis Implantation
(methods)
- Surgical Mesh
- Suture Techniques
(instrumentation)
- Tissue Adhesives
(pharmacology)
- Treatment Outcome
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