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find Keyword "Tension-free" 15 results
  • Experience of Transabdominal Preperitoneal Space Tension-Free Repair for Inguinal Saddle Hernia

    Objective To summary the experience of transabdominal preperitoneal space tension-free repair for inguinal saddle hernia. Methods 〗The clinical data of 151 cases of inguinal saddle hernias underwent transabdominal preperitoneal space tension-free repair with Prolene hernia system (PHS) were retrospectively analyzed. The operative time, postoperative pain, hospital stay, recurrence and postoperative complications were observed. Results The average operative time in unilateral hernias was (29.8±9.6) min. Postoperative complications included one case of pain in groin and 4 cases of scrotum edema. No incision infection and mortality occurred. Postoperative duration of hospital stay was 3 to 5 days. All cases were followed up for 1-5 years and no recurrence happened. Conclusion 〗Transabdominal preperitoneal space tension-free repair for inguinal saddle hernia by PHS is safe and reliable.

    Release date:2016-09-08 10:57 Export PDF Favorites Scan
  • The Experience of Application in Tension-Free Herniorrhaphy Under Local Anesthesia in Senile Inguinal Hernia

    ObjectiveTo investigate the application of tension-free herniarepair under local anesthesia in senile inguinal hernia. MethodsClinical data of 163 cases of senile inguinal hernias with herniorrhaphy under local anesthesia in our department from October 2011 to October 2014 were analyzed retrospectively, including epidural anesthesia 90 patients and local anesthesia 73 patients. ResultsAll patients were successfully completed surgery. Hospital charges in local anesthesia were much cheaper than that in epidural anesthesia group (P=0.002). Hospital days in local anesthesia were much shorter than that in epidural anesthesia group (P=0.035). Lung complication in local anesthesia were much less than that in epidural anesthesia group (P=0.015). Other indicators were no significant difference between the two groups (P > 0.05). ConclusionTension-free herniorrhaphy under local anesthesia in elderly patients is safe, reliable, less invasive method with low costs, slight postoperative pain, and worthy of promotion.

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  • USE OF ALLOGENIC ACELLULAR DERMAL MATRIX IN ABDOMINAL WALL HERNIA AND DEFECT REPAIR IN 31 CASES

    Objective To summarize the cl inical effect of allogenic acellular dermal matrix in repair of abdominal wall hernia and defect. Methods The cl inical data were analyzed retrospectively from 31 patients with abdominal wall hernia and defect repaired by allogenic acellular dermal matrix between March 2007 and November 2009. There were 19 males and 12females with an age range of 10-70 years (median, 42 years), including 6 abdominal wall defects caused by abdominal wall tumor resection, 4 patchs infection after abdominal wall hernia repair using prosthetic mesh, 2 incisional hernia, 1 parastomal hernia, 1 recurrent parastomal hernia receiving mesh repair, 1 mesh infection caused by parastomal hernia repair using prosthetic patch, 3 mesh infection caused by tension free inguina after hernia repair, and 13 inguinal hernia. There were 12 patients with contaminated or infectious wound. The disease duration was from 1 to 34 months (6 months on average). The defect size of abdominal wall ranged from 6 cm × 4 cm to 19 cm × 10 cm. Abdominal wall hernia or defect underwent repair using allogenic acelluar demall matrix. Results Of the 31 patients, 29 patients recovered with primary wound heal ing. Chronic sinus tract occurred in 1 patient and the wound was cured by change dressing. Wound dehiscence and patch exposure occurred in 1 patient, and second heal ing was achieved after change dressing. All the 31 patients were followed up 6-36 months, no abdominal wall hernia or hernia recurrence occurred in other patients except 1 patient who had abdominal bulge. And no foreign body sensation or chronic pain in wound area occurred. Conclusion It is feasible and safe to use allergenic acellular dermal matrix patch for repair of abdominal wall hernia or soft tissue defect, especially in contaminated or infectious wound.

    Release date:2016-09-01 09:03 Export PDF Favorites Scan
  • Clinical Comparison between Tension-Free Vaginal Tape and Tension-Free Vaginal Tape-obturator for Female Stress Urinary Incontinence

    ObjectiveTo compare the clinical outcome of tension-free vaginal tape (TVT) and TVT-obturator (TVT-O) for female stress urinary incontinence (SUI). MethodsSixty-one female SUI patients were included in our study, in which 33 received TVT procedure and 28 received TVT-O procedure. The patients were followed up for 1 to 62 months post-operatively, averaging at 22 months. Cure was defined as no leakage during the stress test and no residual urine showed by B ultrasound, improvement as less leakage during the stress test after operation, and inefficacy as leakage during the stress test and no difference was detected after operation. ResultsAge and disease course were not significantly different between the two groups (P>0.05). All patients underwent TVT or TVT-O procedure successfully. Time of TVT ranged from 26 to 45 min averaging at (35.5±4.3) minutes, and it was significantly different from the time of TVT-O which ranged from 15 to 20 min averaging at (7.2±3.1) minutes (P<0.05). Bleeding during the surgery was not significantly different between the two groups (P>0.05). The rate of complications occurring during TVT-O procedure was significantly less and milder than that during the TVT procedure (P<0.05). The cure rate and improvement rate indicated no significant differences between the two groups (P>0.05). ConclusionThe evidence available indicates that TVT and TVT-O procedure are both effective and safe for female SUI. Compared with TVT, TVT-O procedure has the advantages of being more convenient, shorter operation time, being less invasive, and fewer complications, and it may be more suitable for female SUI.

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  • TREATMENT OF FEMALE STRESS URINARY INCONTINENCE WITH TENSION-FREE VAGINAL TAPE

    Objective To investigate the indication, approaches andpreventionof complications in treatment of female stress urinary incontinence(SUI) with tension-free vaginal tape (TVT). Methods From September 2003 to December 2004, 40 cases of female stress urinary incontinence were treated, including 8 cases in association with cystocele or rectocele and 1 case in association with uterine prolapse. They ranged from 30 to 70 years in age with an average of 56.3years. The disease course was 1.42 years(7.2 years on average). All patients received TVT. In the patients suffering from uterine prolapse and cystocele or rectocele, butterfly-shaped mesh patch was applied. Results All patients achieved satisfactory results.The complications included slight dysuria(2 cases),vesical perforation(1 case) and pelvic hematoma(1 case) and cleared up after treating. All cases were followed up 1 to 15 months and the results were satisfactory. No urinary incontinence and no dysuria reoccurred. Conclusion TVT is effective for SUI.

    Release date:2016-09-01 09:25 Export PDF Favorites Scan
  • Effectiveness and Safety of Tension-free Vaginal Tapes versus Burch Colposuspension for Female Stress Urinary Incontinence: A Systematic Review and Meta-analyses of Randomized Controlled Trials

    Objective To evaluate the effectiveness and safety of tension-free vaginal tapes (TVT) compared with Burch colposuspension for female stress urinary incontinence (SUI). Methods We searched MEDLINE (1966 to October 2007), EMBASE (1988 to October 2007), Cochrane Central Register of Controlled Trials (1993 to October 2007), CMCC (1979 to October 2007) and CNKI (January 1979 to October 2007). We collected randomized controlled trials (RCTs) comparing TVT with Burch colposuspension in the treatment of SUI. Data were extracted and evaluated by two reviewers independently. The Cochrane Collaboration’s RevMan 4.2 was used for data analyses. Results Ten RCTs reporting data on effectiveness and safety of TVE versus Burch colposuspension were included. Meta-analyses showed that TVT was superior to Burch colposuspension as measured by the overall cure rate (OR 1.73; 95%CI 1.26 to 2.38; P=0.0007), negative stress test (OR 2.54; 95%CI 1.71 to 3.78; Plt;0.00001) and negative pad test (OR 1.67; 95%CI 1.16 to 2.41; P=0.006). The total complication rate was higher after TVT (OR 1.39; 95% CI 1.08 to 1.80; P=0.01), while the re-operation rate was significantly higher after Burch colposuspension (OR 0.29; 95%CI 0.10 to 0.80; P=0.02). The incidences of haematoma (OR 1.06; 95% CI 0.39 to 2.84; P=0.91), urinary tract infection (OR 1.27; 95% CI 0.64 to 2.52; P=0.50) and lower urinary tract symptoms (OR 1.20; 95% CI 0.89 to 1.62; P=0.23) were similar after TVT and Burch colposuspension. Conclusion The evidence for short-term superiority of TVT is currently limited. Although the re-operation rate is lower, the risk of bladder or vaginal injury is higher with TVT. Methodologically sound and adequately powered RCTs with long-term follow-up are needed.

    Release date:2016-09-07 02:12 Export PDF Favorites Scan
  • Cause and Treatment of Chronic Pain after Tension-Free Repair of Inguinal Hernia

    Objective To explore the cause and treatment of chronic pain after tension-free repair of inguinal hernia. Methods 〗The clinical data of 426 cases with inguinal hernia underwent the tension-free hernioplasty during February 2002 to September 2007 were retrospectively analyzed. Results 〗Tension-free hernioplasty was performed to all patients. According to operative methods, they were divided into two groups: polypropylene filling group (n=210) and expanded polytetrafluoroethylene (e-PTFE) mycromesh group (n=216). The chronic pain rate after operation, polypropylene filling group (9.0%, 19/210) was significantly higher than e-PTFE mycromesh group (4.2%, 9/216), P<0.05. Conclusion 〗The tension-free repair by e-PTFE mycromesh has less pain in the inguinal hernia due to the material is more suitable to human physiology, more soft and light, with less complications.

    Release date:2016-09-08 10:57 Export PDF Favorites Scan
  • Comparative Analysis of Local Anaesthesia and Epidural Anaesthesia in Tension-Free Herniorrhaphy

    Objective To investigate the most suitable anaesthesia method for the tension-free herniorrhaphy.Methods A total of 422 unilateral inguinal hernia cases from 2002 to 2005 were collected and randomly divided into the local anaesthesia group and epidural anaesthesia group. Observation indices and some relative data, such as operative duration, date of ambulation, date of foodintake, length of hospital stay, operation-correlated complications, anaesthesia complications, usage rate of ancillary drug, satisfactory rate for anesthesia, cost of hospitalization, were included and recorded in the questionnaire, and all the patients who took the tension-free herniorrhaphy were asked to answer it as the follow-up research. Results It was found that the occurrence of postoperative anaesthetic complications, the cost of hospitalization, length of stay of local anaesthesia group were significantly less than those of epidural anaesthesia group, and the date of moving and the date of foodintake were also significantly earlier than those of the other group (P<0.05). However, there was no significant difference of operative duration, postoperative recovery situation and the satisfactory rate between two groups (P>0.05).Conclusion The local anaesthesia is suitable for most of the tension-free herniorrhaphy, and it may be used as the conventional anaesthetic method.

    Release date:2016-09-08 11:49 Export PDF Favorites Scan
  • EFFECTIVENESS OF PREPERITONEAL HERNIORRHAPHY WITH Ultrapro Plug MESH FOR UMBILICAL HERNIA REPAIR IN ADULTS

    Objective To explore the effectiveness of preperitoneal herniorrhaphy with Ultrapro Plug (UPP) mesh for umbilical hernia repair in adults. Methods Between September 2011 and June 2015, 71 patients with umbilical hernia underwent preperitoneal herniorrhaphy with UPP mesh. There were 26 males and 45 females, aged 19-92 years (mean, 54.3 years). The disease duration was 45 days to 30 years (median, 18 months). Umbilical hernia was diagnosed through physical examination, ultrasound, and other relevant auxiliary examination. According to American Society of Anesthesiologists (ASA) classification, 12 cases were rated as grade Ⅰ, 34 cases as grade Ⅱ, 21 cases as grade Ⅲ, and 4 cases as grade Ⅳ. The operation time, postoperative hospitalization time, complication, and recurrence were recorded. Results The diameter of hernia ring ranged 0.5-3.0 cm (mean, 1.8 cm). There was no vessel or intestine injury. The operation time was 12-35 minutes (mean, 22.4 minutes); postoperative hospitalization time was 12-48 hours (mean, 16.3 hours). Fat liquefaction of incision occurred in 2 cases, and primary healing of incision was obtained in the other cases. Sixty-nine patients were followed up 8-51 months (median, 28 months). Hernia recurrence and patch infection occurred in 1 case respectively during follow-up. No postoperative foreign body sensation and chronic pain occurred. Conclusion Repairing umbilical hernia in adults with UPP mesh should be safe and reliable, because it has the advantages of short operation time, short hospital stay, less complication, and lower incidence of recurrence.

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  • Cost-Effectiveness Analysis of Day Surgery Versus Inpatient Surgery for Tension-Free Herniorrhaphy

    ObjectiveTo explore the surgical effect and cost-effectiveness of day surgery versus inpatient surgery for tension-free herniorrhaphy. MethodsA total of 100 cases of unilateral inguinal hernia who treated in West China Hospital of Sichuan University from Jan. 2010 to Sep. 2010 were collected prospectively, and were randomly divided into 2 groups: day surgery group (50 cases) and inpatient surgery group (50 cases). Comparison of the surgical effect and cost-effectiveness of day surgery versus inpatient surgery was performed. ResultsThere was no significant difference in the operation time, blood loss during the operation, incidence of urinary retention, scrotal edema fluid, incision foreign body sensation, and total complications, the time of get out of bed after surgery, and the time of returning to work after surgery (P > 0.05), but the hospital stay of day surgery group was shorter than that of inpatient surgery group (P < 0.05). The total cost of day surgery group was lower than that of inpatient surgery group (P < 0.05). There was no significant difference in the preoperation cost and introperative cost (P > 0.05), but the postoperative cost of day surgery group was lower than that of inpatient surgery group (P < 0.05). In the preoperation cost, there was no significant difference in the intraoperative monitoring fee, anesthesia and surgery materials fee, and drug charges (P > 0.05), but in the postoperative cost, the drug charges, nursing care fee, bed fee, and escort fee of day surgery group were all lower than that of inpatient surgery group (P < 0.05). ConclusionsThe effect of day surgery for tension-free herniorrhaphy is similar with inpatient surgery. But compared with inpatient surgery, the total cost of day surgery is lower, turn-over rate is higher, so it improves utilization of medical resources, reduces economic burden, and also reduces the medical burden of the country.

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