Elsevier

Surgery

Volume 151, Issue 4, April 2012, Pages 550-555
Surgery

Original Communication
NBCA medical adhesive (n-butyl-2-cyanoacrylate) versus suture for patch fixation in Lichtenstein inguinal herniorrhaphy: A randomized controlled trial

https://doi.org/10.1016/j.surg.2011.09.031Get rights and content

Background

We compared the effectiveness of n-butyl-2-cyanoacrylate (NBCA) and traditional suture for patch fixation in Lichtenstein tension-free herniorrhaphy for inguinal hernias.

Methods

A total of 110 patients with primary unilateral inguinal hernia were assigned randomly to either experimental or control groups. In the experimental group, NBCA adhesive was used during Lichtenstein herniorrhaphy; traditional suture was used in the control group. We evaluated operation time, postoperative duration of stay, visual analogue scale (VAS) pain score, incidence of chronic pain and hematoma formation, and hernia recurrence.

Results

There was no hernia recurrence or wound infection in either group. In the experimental group, 2 local hematomas occurred while no patients experienced chronic postoperative pain; in the control group, 10 hematomas occurred, and 6 patients experienced chronic pain. There was no difference in postoperative duration of stay between the groups (P > .05), but the experimental group had a lesser operation time and postoperative VAS score (P < .05).

Conclusion

The use of NBCA medical adhesive in tension-free inguinal herniorrhaphy is effective and safe.

Section snippets

Methods

This randomized, single-blind study was conducted at the Hernia and Abdominal Wall Surgery department of Beijing Chao-Yang Hospital, Capital Medical University, between January 2010 and April 2010. Patients were enrolled if they met the inclusion criteria, including: (1) clinical diagnosis of primary unilateral inguinal hernia; (2) age >18 years; and (3) no significant cardiopulmonary, hepatic, or renal impairment, and no contraindications for surgery. Exclusion criteria included: (1) bilateral

Results

Of 450 patients with inguinal hernias who were seen at our department between January 2010 and April 2010, 110 met the inclusion and exclusion criteria and were enrolled in this study. Patient demographic and disease characteristics shown in Table I, Table II groups were comparable.

In the experimental group, there were 45 males and 10 females with a mean age of 63 ± 10 years (range, 40–78). Their mean body mass index (BMI) was 25 ± 2 kg/m2 (range, 22–29 kg/m2). With respect to comorbidities, 10

Discussion

In our study, we compared the effectiveness and safety of a chemical adhesive with traditional suture for mesh patch fixation in Lichtenstein inguinal herniorrhaphy. The results showed that in terms of operation time, pain 24 hours after surgery, and postoperative complications, the chemical adhesive exhibited advantages over traditional sutures.

Most cases of chronic pain after tension-free inguinal herniorrhaphy arise from suture tension and subsequent nerve compression.2, 4 Therefore, the

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