Revista Colombiana de Cirugía
versão impressa ISSN 2011-7582
DOMINGUEZ, Luis Carlos; SANABRIA, Álvaro; VEGA, Valentín e OSORIO, Camilo. Which is the utility of biological glues in open and laparoscopic inguinal herniorrhaphy?. rev. colomb. cir. [online]. 2011, vol.26, n.4, pp. 260-272. ISSN 2011-7582.
Introduction: Different strategies for reducing postoperative pain in inguinal herniorrhaphy exhibit varying degrees of clinical effectiveness. This article is a critical review of the scientific literature evaluating the effectiveness of mesh fixation with biological glue in laparoscopic and open surgery (Lichtenstein technique and mesh plug), compared with non fixation or conventional fixation. Methods: A search of the scientific literature following the Best BETs (Best Evidence Topics) methodology was carried out in order to identify articles that compare the mesh fixation during inguinal hernia repair with biological glue against non fixation or conventional fixation. The articles were reviewed according to the criteria for assessing literature of the Journal of the American Medical Association. We extracted data on the effectiveness of the intervention and analyzed primary outcomes such as postoperative pain, bleeding, hematoma, infection, and seroma. As secondary outcomes we analyzed the cost, length of hospital stay, return to work and operating time. Results: Eleven randomized studies were identified. In transabdominal preperitoneal herniorrhaphy (TAPP) the use of biological glue may reduce postoperative pain (assessed by visual analog scale). This advantage is not fully established in the open herniorrhaphy. In the total extraperitoneal herniorrhaphy (TEP), postoperative pain is greater with the use of biological glues. No documented differences appear in the rates of recurrence or infection, and the frequency of seroma and hematoma appeared variable in all techniques for hernia repair (TAPP, TEP and open). The cost is higher when using biological glue. Conclusions: The use of biological glue for mesh fixation during an inguinal herniorrhaphy is not currently recommended.
Palavras-chave : hernia; inguinal; surgery; laparoscopy; prostheses and implants; fibrin tissue adhesive.