Description
AIM: Retrospective analisis of the outcome in the immediate and late postoperative care of inguinal hernioplasty according to 3 mesh techniques. Matherial and Methods: From 1997 until 2005, a 9-year period, 562 inguinal hernioplasty procedures were conducted in 496 patients at Surgery I Ward of University Hospitals of Coimbra. Male gender (n=453) was the most predominant and the mean age was 59 years [16-98]. Elective repair was performed in the majority of patients (n=472). The most frequent inguinal herniation was indirect hernia (n=314), followed by direct hernia (n=320) and mixed (direct and indirect) hernia (n=28). Polypropylene mesh was employed as “patch”, “patch and plug” or PHS®. A retrospective analysis of the patient`s clinical records was done and a questionnaire was sent to each patient in October 2006. A statistical analysis was performed.Results: Postoperative mortality was 0%. However, immediate postoperative complications occurred in 21 (4.2%) procedures, such as: haematoma (n=8; 38%), urinary retention (n=5; 23.8%), bruises (n=4; 19%), wound infection (n=1; 4.8%), cystitis (n=1; 4.8%), paralytic ileus (n=1; 4.8%) and urticariform reaction (n=1; 4.8%). The questionnaire was answered by 239 (48.2%) patients, in whom 266 inguinal hernioplasty procedures were performed. Recurrence rate was 2.2% (n=6). Recurrent indirect inguinal hernia was the most common (n=5). Mesh for recurrent hernia repair was employed as “patch” (n=2) and “patch and plug” (n=4). Primary recurrence occurred in 5 cases and secondary recurrence in one. Conclusions: Inguinal hernia occurred mostly in man and as an indirect hernia. Polypropylene mesh was employed mainly as “patch” and “patch and plug”. There were no significant differences between the mesh techniques and the postoperative complications, as well as chronic groin pain and recurrence rate. Objectivo: análise retrospectiva dos resultados no pós-operatório imediato e à distância do tratamento cirúrgico de hernioplastias inguinais com três tipos de próteses, realizadas no Serviço de Cirurgia I. Material e métodos: De 1997 a 2005 (nove anos) foram submetidos a hernioplastia 496 doentes (453 homens e 43 mulheres), correspondentes a 562 hérnias inguinais, com idade média de 59,4 anos (limites: 16 - 98). A maioria (472) foi tratada electivamente, tendo sido realizadas apenas 24 de urgência. Das 562 hérnias, 314 eram indirectas, 220 directas e 28 mistas. O tratamento cirúrgico foi efectuado através da aplicação de prótese de polipropileno sob a forma de: “patch”, “patch e plug”, ou PHS®. Procedeu-se à consulta de processos clínicos, ao envio de inquérito (Outubro/2006) (em anexo), à observação de doentes com suspeita de recidiva e à análise estatística. Resultados: Não houve mortalidade operatória e a morbilidade global foi de 4,2 % (21 casos): hematoma 8 (38%); retenção urinária 5 (23,8%); equimose 4 (19%); infecção da sutura 1 (4,8%); infecção urinária 1 (4,8%); íleus paralítico 1 (4,8%); reacção urticariforme 1 (4,8%). Responderam aos inquéritos 239 doentes (48,2 %), correspondentes a 266 hérnias. A taxa global de recidiva foi de 2,2 % (6 hérnias) que ocorreu nas indirectas em 5 doentes, nas directas em 1. As técnicas usadas nesses pacientes foram: “patch” (2); “patch e plug” (4). Houve 5 recidivas primárias e 1 secundária. Conclusões: As hérnias inguinais afectaram sobretudo indivíduos do sexo masculino e apresentaram-se na maior parte dos casos sob o tipo indirecto. Foram tratadas preferencialmente pelas técnicas de “patch” e “patch e plug”. Não houve diferenças significativas entre o tipo de prótese utilizada e as complicações pós-operatórias, dor na região inguinal e taxa de recidiva.
; Rodrigues, A.; Interna Complementar de Cirurgia Geral 
