Results of Implementation of a Multimodal Perioperative Protocol of Fast Track Recovery in Patients with Groin Hernias

V.I. Palamarchyk, V.M. Lysenko, M.Yu. Krestianov, R.O. Balatsky, O.A. Potapov, V.I. Zubal, D.E. Makhmudov

Abstract


The article presents the results of using a multimodal program of Fast Track Recovery in patients with inguinal hernias, who underwent transabdominal preperitoneal (TAPP) hernia repair. The aim of this study was to improve the short-term results in this group of patients. Patients of the main group underwent intrathecal anesthesia with right superficial blockade of the cervical plexus and pre-anesthesia of troacar wounds, and hydropreparation of the peritoneum. In the control group, endotracheal anesthesia was performed. In all patients included in the study and control groups, during transabdominal preperitoneal hernia repair, we have used volumetric polypropylene prosthesis with anatomical shape, which does not require additional fixation after its implantation into the preperitoneal space. Connecting the edges of the peritoneum above the mesh implant was performed using the technology of electric welding of biological tissues.
Subjective assessment of the quality of life and satisfaction with treatment results was statistically significantly better in the study group of patients. Laparoscopic transabdominal preperitoneal hernioplasty combined with multimodal program of Fast Track Recovery is a safe treatment strategy that can be an alternative to standard methods of treatment and rehabilitation of patients with inguinal hernia.


Keywords


laparoscopic hernia repair; TAPP; groin hernia; multimodal program of Fast Track Recovery; welding of biological tissues

References


Бишовець С.М. Реґіонарна анестезія операцій на ключиці // Острые и неотложные состояния в практике врача. — 2011. — № 2. — ​С. 53-54.

Малрой М. Местная анестезия: Пер. с англ. — ​М.: БИНОМ. Лаборатория знаний, 2003. — 301 с.

Патон Б.Е. Электрическая сварка мягких тканей в хирургии / Б.Е. Патон // Автоматич. сварка. — 2004. — № 9. — ​С. 7-11.

Рамфелл Д.П., Нил Д.М., Вискоуми К.М. Регионарная анестезия: самое необходимое в анестезиологии: Пер. с англ. — ​М.: МЕДпресс-информ, 2007. — 272 с.

Aguilar-Nascimento J.E. Clinical benefits after the implementation of a multimodal perioperative protocol in elderly patients / J.E. Aguilar-Nascimento, A.B. Salomгo, C. Caporossi et al. // Arq. Gastroenterol. — 2010. — 47(2).

Amirzargar M.A. Mesh fixation compared with nonfixation in transabdominal preperitoneal laparoscopic inguinal hernia repair / M.A. Amirzargar, M. Mohseni, J. Poorolajal // Surg. Technol. Int. — 2013. — № 23. — ​Р. 122.

Birk D. Self-gripping Parietene and Parietex Progrip mesh laparoscopic hernia repair: have we found the ideal implant? / D. Birk, C.G. Pardo // Surg. Technol. Int. — 2012. — № 22. — ​Р. 93-100.

Cheong K.X. Inguinal hernia repair: are the results from a general hospital comparable to those from dedicated hernia centres / K.X. Cheong, H.Y. Lo, J.X. Neo [et al.] // Singapore Med. J. — 2014. — ​Vol. 55, № 4. — ​P. 191-197.

Courtney C.A. Outcome of patients with severe chronic pain following repair of groin hernia / C.A. Courtney, K. Duffy, M.G. Serpell, P.J. O’Dwyer // British Journal of Surgery. — 2002. — № 89. — ​Р. 1310-1314.

Ger R. Management of indirect inguinal hernias by laparoscopic closure of the neck of the sac / R. Ger, K. Monroe, R. Duvivier [et al.] // Am. J. Surg. — 1990. — № 159. — ​Р. 370-373.

Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation / H. Kehlet // Br. J. Anaesth. — 1997. — 78. — 606-617.

LeBlanc K. Hernias: inguinal and incisional / К. LeBlanc, А. Kingsnorth // Lancet. — 2003. — ​Vol. 362, № 9395. — ​Р. 1561-1571.

Sajid M.S. A meta-analysis examining the use of tacker fixation versus no-fixation of mesh in laparoscopic inguinal hernia repair / M.S. Sajid, N. Ladwa, L. Kalra, K. Hutson, P. Sains, M.K. Baig // International Journal of Surgery. — 2012. — № 10. — ​Р. 224-231.

Taylor C. Laparoscopic inguinal hernia repair without mesh fixation, early results of a large randomised clinical trial / Taylor C., Layani L., Liew V., Ghusn M., Crampton N., White S. // Surg. Endosc. — 2008. — 22. — ​Р. 757e62.

Wind J. Systematic review of enhanced recovery programmes in colonic surgery. / J. Wind, S.W. Polle, P.H. Fung Kon Jin, C.H. Dejong, M.F. von Meyenfeldt, D.T. Ubbink, D.J. Gouma, W.A. Bemelman // Br. J. Surg. — 2006 Jul. — 93(7). — 800-9.




DOI: https://doi.org/10.22141/2224-0586.6.77.2016.82170

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