| Objective:To investigate the clinical efficacy of Mesh-plug patch hernioplasty(Rutkow) and the Polyprolene Hernia System(PHS) by comparing operative process, postoperative complications of Rutkow and PHS in different type inguinal hernia.Method:1.The clinical data of 172 cases of inguinal hemia treated by open tension-free hernioplasty in our department from March 2002 to December 2007 were analyzed retrospectively.2.PHS gruoup was performed in 70 cases of inguinal hernia from March 2002 to March 2004. Rutkow group was performed in 102 cases of inguinal hernia from April 2004 to December 2007.Surgical outcomes and follow-up records were compared between PHS group and Rutkow group .3. Statistic analysis was applicated to the operation time,the quantity of bleeding,the postoperative activity out of bed days,the time in hospital postoperative,the postoperative time to normal activities,the duration time of pain,the recover time and the cases of complication that included wound infection, recurrence, wound pain and sense of wound discomfort.4. Inspection in hospital period, the outpatient service along with examine, the telephone, the questionnaire and the letter investigation method carry on the follow-up visit.The follow-up visit time are 6-72 months. Follow-up visit rate of Rutkow group is 92.6 % and PHS group is 95.7%.5. Chi square test was used to analyze the quantity data and t test was used to analyze the quality data by the SPSS 11.5 statistic software package.Results:1. Surgeries are smooth.There is no significantly statistical difference in the sex, the age, the inguinal hernia type, complications in two groups of patient. (P>0.05).2. The surgery time and quantity of bleeding are 50.2±7.8 minutes and 10±2.2ml respectively in Rutkow group and 75.0±7.9 minute and 40±3.5ml respectively in PHS group. There is significantly statistical difference in surgery time and quantity of bleeding. (P<0.05).3. 5 cases recurred in Rutkow group and 1 case recurred in PHS group. There is no significantly statistical difference in the total recurring rate in two groups(P>0.05).Recurring rate is 9.09% in III, IV type hernia of the Rutkow group and 2.70% in the PHS group.There is no significantly difference in two groups (P>0.05).However ,the PHS group recurring rate is obviously lower than Rutkow group.4. There is 15 cases with wound ache in the Rutkow group (13 cases with slight ache,1 case with midrange ache, 1 case with the severe ache), PHS group have 9 cases with wound ache (8 cases with slight ache, 1 case with midrange ache). There is no difference in the ache degree in two groups(p>0.05). There is 9 cases(8.82%)with sense of wound discomfort in Rutkow group but 1 case(1.43%)in PHS group.There is significantly differncece in the sense of wound discomfort between Rutkow group and PHS group (P<0.05).Conclusion:The Rutkow and PHS operations are security, effective, low recurrence rate.Their indications are wider than tradition hernia operation. The Rutkow has grace such as the short surgery time, the few quantity of bleeding, small damage.Comparatively speaking,Rutkow has feature such as high recurrence rate, the high sense of wound discomfort rate in III,IV type hernia.The PHS is suitable for III,IV type inguinal hernia patient with large defection in hernia ring, it has the few sense of wound discomfort and low recurrence rate. Treating complications in perioperative period,specification operation and preventing wound infection are key to reduce recurrence rate and complications. |
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