Hernia : the journal of hernias and abdominal wall surgery
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To date, no studies have investigated how the preoperative management of clopidogrel, an irreversible antiplatelet agent, influences the outcome following minor operative procedures. The purpose of this study is to determine if clopidogrel use within 7 days of inguinal herniorrhaphy increases the postoperative risk for bleeding-related morbidity or mortality. ⋯ Clopidogrel use within 7 days of inguinal herniorrhaphy did not increase the risk for perioperative bleeding complications. No mortalities, readmissions, or ICU requirements occurred, regardless of the timing of clopidogrel cessation. The increased risk for hospital admission and length of stay seen in group A is likely to be attributable to nonbleeding-related patient factors rather than clopidogrel use. Thus, it may not be necessary to interrupt clopidogrel therapy prior to inguinal herniorrhaphy in high-risk patients.
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Multicenter Study Comparative Study
Open tension-free Lichtenstein repair of inguinal hernia: use of fibrin glue versus sutures for mesh fixation.
To investigate pain and other complications following inguinal hernioplasty performed by the Lichtenstein technique with mesh fixation by fibrin glue or sutures. ⋯ Tissucol fibrin glue for mesh fixation in the Lichtenstein repair of inguinal hernia shows advantages over sutures, including lower incidence of complications such as pain, numbness, and discomfort, and should be considered as a first-line option for mesh fixation in hernioplasty.
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Comparative Study
The transinguinal preperitoneal hernia correction vs Lichtenstein's technique; is TIPP top?
Chronic pain is the main drawback of the Lichtenstein procedure for inguinal hernia repair, with a reported incidence of 15-40%. The transinguinal pre-peritoneal (TIPP) technique seems to be associated with less chronic pain, comparable to the total extra peritoneal (TEP) technique. The aim of this study was to evaluate 3 years of TIPP and Lichtenstein experience since the start of our Hernia Center Brabant in January 2006. ⋯ This retrospective study design revealed no significantly better results for the TIPP procedure as compared to the Lichtenstein technique. The incidence of chronic pain reported in this retrospective study has been low in both groups since the opening of the Hernia Center Brabant. These results form the basis for a prospective randomized clinical trial comparing the TIPP and Lichtenstein techniques.
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A traumatic diaphragmatic hernia is a well-known complication following blunt abdominal or penetrating thoracic trauma. Although the majority of cases are diagnosed immediately, some patients may present later with a diaphragmatic hernia. It occurs in approximately 3% of abdominal traumas. ⋯ The patient developed empyema in the postoperative period. Our patient is the twelfth reported case of a tension fecopneumothorax resulting from traumatic diaphragmatic herniation. This paper reviews all cases, including the diagnostic workup, operative approach, and expected postoperative course of this unusual condition.
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Randomized Controlled Trial Comparative Study
Parecoxib sodium in the treatment of postoperative pain after Lichtenstein tension-free mesh inguinal hernia repair.
This prospective, randomized, double-blind study compared the analgesic efficacy and safety of parecoxib sodium versus lornoxicam and diclofenac, after Lichtenstein tension-free mesh inguinal hernia repair. ⋯ Multiple-day administration of parecoxib 40 mg twice daily is more effective than equivalent doses of lornoxicam and diclofenac, and generally better tolerated than diclofenac after Lichtenstein tension-free mesh inguinal hernia repair.