Volume : 7, Issue : 6, June - 2018

COMPARATIVE STUDY BETWEEN N-BUTYL-2-CYANOACRYLATE VERSUS SUTURED MESH FIXATION IN INGUINAL HERNIA

Dr Badareesh Koganti, Dr A S Prasad, Dr V Radha Krishna Murthy

Abstract :

<p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%;mso-layout-grid-align:none;text-autospace:none"><b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&#10;&quot;MS Mincho&quot;">Introduction</span></b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;&#10;mso-fareast-font-family:&quot;MS Mincho&quot;;mso-bidi-font-weight:bold">: </span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">Lichtenstein tension free Hernioplasty is currently the first choice to repair primary groin hernias. However, complications associated with sutured mesh fixation following open groin hernia repair, such as chronic irritation and painare commonly seen. To avoid these problems and reduce the risk of chronic pain, different methods of mesh fixation have been considered and mainly tissue compatible glues like N-butyl 2-cyanoacrylate glues. This study is designed to evaluate<span style="mso-spacerun:yes">&nbsp; </span>to demonstrate that the use of cyanoacrylate<span style="mso-spacerun:yes">&nbsp; </span>glue can reduce post-herniorraphy pain.</span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&#10;&quot;MS Mincho&quot;;mso-bidi-font-weight:bold"><o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%;mso-layout-grid-align:none;text-autospace:none"><b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&#10;&quot;MS Mincho&quot;">Material and methods</span></b><span lang="EN-IN" style="font-family:&#10;&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&quot;MS Mincho&quot;;mso-bidi-font-weight:&#10;bold">: A total of 100 patients were studied. </span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;color:black">Patients are categorised into 50 for each group.Group A: Suture mesh fixationGroup B: Glue mesh fixation</span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&#10;&quot;MS Mincho&quot;;mso-bidi-font-weight:bold"><o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%;mso-pagination:none"><b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&quot;MS Mincho&quot;">Results:</span></b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&#10;&quot;MS Mincho&quot;">M</span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;color:black;mso-font-kerning:12.0pt;&#10;mso-fareast-language:EN-IN">ean age was of </span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;color:black">50.88 &plusmn; 9.67 years</span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&#10;&quot;Times New Roman&quot;;color:black;mso-font-kerning:12.0pt;mso-fareast-language:&#10;EN-IN"> in standard prolene suture group&amp;</span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;color:black">44.9 &plusmn; 14.3 years</span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&#10;&quot;Times New Roman&quot;;color:black;mso-font-kerning:12.0pt;mso-fareast-language:&#10;EN-IN">in<span style="mso-spacerun:yes">&nbsp; </span>N-butyl cyanoacrylate group. Patients presented with swelling in the groin with or without pain or only with pain ranging from &lt;6 months to &gt;5 years.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%;mso-pagination:none"><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;;&#10;color:black;mso-font-kerning:12.0pt;mso-fareast-language:EN-IN">Highest number of patients were in the age group of 40-49 years in N butyl cyanoacrylate group and in the age group of 50-59 years in standard prolene fixation of mesh group. Hospital stay in cases group was 4.82 days and in control group was 6.48 days. Pain after 1 month was seen only in 5 patients in N butyl cyanoacrylate mesh fixation group and whereas it was more in Standard ProleneMesh fixation group i.e.16 patients. Hence, the case group is superior to control group.</span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&#10;&quot;MS Mincho&quot;"><o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;text-align:&#10;justify;line-height:200%;mso-pagination:none"><b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&quot;MS Mincho&quot;">Conclusion</span></b><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&#10;&quot;MS Mincho&quot;;mso-bidi-font-weight:bold">: </span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&quot;Times New Roman&quot;;&#10;color:black;mso-font-kerning:12.0pt;mso-fareast-language:EN-IN">Use of N butyl cyanoacrylate glue for Lichtenstein hernia repair is more efficacious than regular prolene suture mesh fixation and also has the potential to reduce the post-operative pain and duration of hospital stay.</span><span lang="EN-IN" style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&quot;MS Mincho&quot;;&#10;mso-bidi-font-weight:bold"><o:p></o:p></span></p>