Cyanoacrylate Glue Mesh Fixation versus Suture Mesh Fixation in Open Inguinal Hernia Repair

摘要

Aim of the work: surgical sealants (adhesives) have been widely used in surgery to prevent air leaks (from holes in diseased soft tissues such as lung), liquid leaks (including hemostasis, as for oozing) and as adhesives (to bond two separate tissues, but very rarely). They have many advantages over traditional techniques (i.e., sutures and staples) such as reducing both operative time and physical load on patients. Sutures have been most extensively used for wound closure, though they have shortcomings such as the highly skilled procedures involved, the long time required for wound closure, and the postoperative removal of non-bioabsorbable Sutures. Methods: forty male patients with primary unilateral groin hernia were randomized to undergo open hernia repair with suture fixation ( Group B ) or cyanoacrylate glue fixation of the mesh ( Group A ). Primary outcome was early and late postoperative pain. Secondary endpoints were use of painkillers after 24 hours, morbidity rate and recurrence rate. Results: early postoperative pain and pain between 48 hours and 1 month after surgery were significantly lower in Group A. Only two patients had chronic pain and both were in Group B. Clinical recurrences were two, both in Group B. Conclusion: cyanoacrylate seemed to be a simple, original, reasonable, feasible, reproducible technique and competitive alternative to the standard tissue-penetrating mesh fixation devices in open inguinal hernioplasty. It is accompanied by a reduction in chronic inguinal pain, with no increase in the early recurrence rate.