OPEN

El-Awady, Saleh; Kotb, Sherif; Morshed, Mossad; Badrawy, Tarek; El-Maadawy, Gamal; Ragab, Elham

doi:10.21608/ejsur.2002.374950

OPEN "TENSION FREE" HERNIOPLASTY VERSUS CONVENTIONAL REPAIR CLINICAL, BIOCHEMICAL AND IMMUNOLOGIC STUDY

Document Type : Original Article

Authors

¹ Department of Surgery, Menoufyia University, Egypt

² Department of Radiodiagnosis, Liver Institute, Menoufyia University, Egypt

³ Department of Clinical Pathology , Mansoura University Hospital, Egypt

10.21608/ejsur.2002.374950

Abstract

Background: Extensive clinical research has been undertaken to assess the outcome following inguinal hernia repair as
over 80 techniques described since 1887 when Bassini reported his method.
Objective: Clinical assessment of postoperative pain on mobilization in tension free hernioplasty and conventional repair.
Objective laboratory study of stress response reflected by the total and differential leucocytic count. Study of the Th1
inflammatory and Th2 compensatory response and their relationship. Measure the systemic inflammatory response of
hernioplasty repair. Evaluate the immediate and 2 years follow up of hernia surgery.
Methods: Forty-five male patients with primary indirect inguinal hernias were treated with elective operations, and
separated into 3 group, group I treated by Bassini hernioraphy group II operated upon using Shouldice procedure group III treated by tension free hernioplasty using polyperoline mesh, another control healthy volunteers were included. Serum venous samples collected at 24h, 72h and in the 7th postoperative day to detect total leucocytic count, differential leucocytic count, interleukin-12, interleukin-13 and glutathione peroxidase.
Results: This study evidences that Lichtension hernia patients had less pain scores, sequential pain score for 1st, 3rd, 7th, 2nd week were 3.5, 2.37, 1.37, 0.46 significant leukocytosis and neutrophilia, polarization towards the inflammatory (Th1)
response, unmodified serum glutathione peroxidase.
Conclusion: Our data show that the Lichtenstein hernia repair induces less pain, useful acute, local inflammatory response followed by limited fibroblastic activity with out dangerous systemic inflammatory response.

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