Factores de riesgo de recurrencia de hernias inguinales
Resumo
Analizar factores relacionados con recurrencia de hernias Inguinal en Hospital Humberto Alvarado Vásquez. Pacientes y Método: Estudio de Casos y Controles. Periodo Enero 2003 - Diciembre 2010, se efectuaron 805 hernioplastias; 57 casos recurrieron, controles 114 asignados al azar. Criterios de exclusión: menor de 15 años, cirugía de urgencia. El análisis estadístico aplicado, pruebas de Chi cuadrado, ANOVA, y razón de probabilidades (OR) con intervalos de confianza del 95%. Resultados: Factores asociados a recurrencia hernia: sexo masculino (p=0.03), mayor de 65 años (p=0.007), obesidad (p=0.0006). Según clasificación de Bendavid los tipos de hernias predominantes en casos T1S3D3 y T2S3D3. La técnica quirúrgica más utilizada en casos fue Bassini OR: 2.68 (1.26-5.72; p=0.005). Se evidenció que las técnicas de Shouldice (p=0.007) y hernioplastia con malla (p=0.0001) constituyen un factor protector. Asimismo hubo una relación significativa de casos con uso nylon 2-0 (p=000.2). El promedio tiempo quirúrgico 50.63 (±26.8) en casos y 41.86(±19.5) en controles. La media tiempo de aparición de recurrencia 2 años (±1.02). Conclusiones: Factores de riesgo de recurrencia: masculino, >65 años, obesidad, técnica quirúrgica Bassini y MacVay; factores protectores técnicas de Shouldice y Hernioplastia con malla. Utilizar siempre hilo monofilamento no absorbibleDownloads
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Referências
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Amid, P. K. (2005). Groin hernia repair: open techniques. World journal of surgery, 29(8), 1046-1051.
Arregui, M. E., & Young, S. B. (2005). Groin hernia repair by laparoscopic techniques: current status and controversies. World journal of surgery, 29(8), 1052-1057.
Barrat, C., Surlin, V., Bordea, A., & Champault, G. (2003). Management of recurrent inguinal hernias: a prospective study of 163 cases. Hernia, 7(3), 125-129.
Bisgaard, T., Bay‐Nielsen, M., Christensen, I. J., & Kehlet, H. (2007). Risk of recurrence 5 years or more after primary Lichtenstein mesh and sutured inguinal hernia repair. British journal of surgery, 94(8), 1038-1040.
Castillo A, Perea A y cols. (1999). Consenso. Hernia Inguinal. Asoc Méx Cir Gral
Cheek, C. M., Black, N. A., Devlin, H. B., Kingsnorth, A. N., Taylor, R. S., & Watkin, D. F. (1997). Groin hernia surgery: a systematic review. Annals of the Royal College of Surgeons of England, 80, S1-80.
Flum D.R, Horvath K. & Koepsell T. (2003). Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann Surg 237(1), 129–135.
Jansen, P. L., Klinge, U., Jansen, M., & Junge, K. (2009). Risk factors for early recurrence after inguinal hernia repair. BMC Surgery, 9(1), 18.
Lau H., Fang C., Yuen W.K. & Patil, N.G. (2007). Risk factors for inguinal hernia in adult males: a case-control study. Surgery. 141(2), 262-6.
Lichtenstein, I. L., Shulman, A. G., & Amid, P. K. (1993). The cause, prevention, and treatment of recurrent groin hernia. The Surgical clinics of North America, 73(3), 529-544.
McCormack, K., Scott, N., Go, P. M., Ross, S. J., & Grant, A. (2003). Laparoscopic techniques versus open techniques for inguinal hernia repair. The Cochrane Library.
Purkayastha, M. S., Chow, M. A., Athanasiou, M. T., Tekkis, P. P., & Darzi, A. (2008). Inguinal hernia. Clinical evidence, 2008.
Richards, S. K., Vipond, M. N., & Earnshaw, J. J. (2004). Review of the management of recurrent inguinal hernia. Hernia, 8(2), 144-148.
Rosemar, A., Angerås, U., Rosengren, A., & Nordin, P. (2010). Effect of body mass index on groin hernia surgery. Annals of surgery, 252(2), 397-401.
Schwartz, S. y Col. (1995). Principios de cirugía. (6ta. ed.) Interamericana. McGraw-Hill. Vol. 2.
Sevonius, D., Gunnarsson, U., Nordin, P., Nilsson, E., & Sandblom, G. (2009). Repeated groin hernia recurrences. Annals of surgery, 249(3), 516-518.
Slater, G. H., Hopkins, G., & Bailey, M. (2001). Mesh compared with non‐mesh methods of open groin hernia repair: systematic review of randomized controlled trials (Br J Surg 2000; 87: 854–9) and Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials (Br J Surg 2000; 87: 860–7). British Journal of Surgery, 88(3), 470-471.
Vrijland, W. W., van Den Tol, M. P., Luijendijk, R. W., Hop, W. C. J., Busschbach, J. J. V., de Lange, D. C. D., ... & Jeekel, J. (2002). Randomized clinical trial of non‐mesh versus mesh repair of primary inguinal hernia. British journal of surgery, 89(3), 293-297.
Amid, P. K. (2005). Groin hernia repair: open techniques. World journal of surgery, 29(8), 1046-1051.
Arregui, M. E., & Young, S. B. (2005). Groin hernia repair by laparoscopic techniques: current status and controversies. World journal of surgery, 29(8), 1052-1057.
Barrat, C., Surlin, V., Bordea, A., & Champault, G. (2003). Management of recurrent inguinal hernias: a prospective study of 163 cases. Hernia, 7(3), 125-129.
Bisgaard, T., Bay‐Nielsen, M., Christensen, I. J., & Kehlet, H. (2007). Risk of recurrence 5 years or more after primary Lichtenstein mesh and sutured inguinal hernia repair. British journal of surgery, 94(8), 1038-1040.
Castillo A, Perea A y cols. (1999). Consenso. Hernia Inguinal. Asoc Méx Cir Gral
Cheek, C. M., Black, N. A., Devlin, H. B., Kingsnorth, A. N., Taylor, R. S., & Watkin, D. F. (1997). Groin hernia surgery: a systematic review. Annals of the Royal College of Surgeons of England, 80, S1-80.
Flum D.R, Horvath K. & Koepsell T. (2003). Have outcomes of incisional hernia repair improved with time? A population-based analysis. Ann Surg 237(1), 129–135.
Jansen, P. L., Klinge, U., Jansen, M., & Junge, K. (2009). Risk factors for early recurrence after inguinal hernia repair. BMC Surgery, 9(1), 18.
Lau H., Fang C., Yuen W.K. & Patil, N.G. (2007). Risk factors for inguinal hernia in adult males: a case-control study. Surgery. 141(2), 262-6.
Lichtenstein, I. L., Shulman, A. G., & Amid, P. K. (1993). The cause, prevention, and treatment of recurrent groin hernia. The Surgical clinics of North America, 73(3), 529-544.
McCormack, K., Scott, N., Go, P. M., Ross, S. J., & Grant, A. (2003). Laparoscopic techniques versus open techniques for inguinal hernia repair. The Cochrane Library.
Purkayastha, M. S., Chow, M. A., Athanasiou, M. T., Tekkis, P. P., & Darzi, A. (2008). Inguinal hernia. Clinical evidence, 2008.
Richards, S. K., Vipond, M. N., & Earnshaw, J. J. (2004). Review of the management of recurrent inguinal hernia. Hernia, 8(2), 144-148.
Rosemar, A., Angerås, U., Rosengren, A., & Nordin, P. (2010). Effect of body mass index on groin hernia surgery. Annals of surgery, 252(2), 397-401.
Schwartz, S. y Col. (1995). Principios de cirugía. (6ta. ed.) Interamericana. McGraw-Hill. Vol. 2.
Sevonius, D., Gunnarsson, U., Nordin, P., Nilsson, E., & Sandblom, G. (2009). Repeated groin hernia recurrences. Annals of surgery, 249(3), 516-518.
Slater, G. H., Hopkins, G., & Bailey, M. (2001). Mesh compared with non‐mesh methods of open groin hernia repair: systematic review of randomized controlled trials (Br J Surg 2000; 87: 854–9) and Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials (Br J Surg 2000; 87: 860–7). British Journal of Surgery, 88(3), 470-471.
Vrijland, W. W., van Den Tol, M. P., Luijendijk, R. W., Hop, W. C. J., Busschbach, J. J. V., de Lange, D. C. D., ... & Jeekel, J. (2002). Randomized clinical trial of non‐mesh versus mesh repair of primary inguinal hernia. British journal of surgery, 89(3), 293-297.
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Publicado
2017-07-27
Edição
Seção
Ciencia y Sociedad
