Assesment of Inflammatory Response Intensity in Early Postoperative Period in Patients After Hernioplasty Operated on with Classic Stoppa Method and Videoscopic TEP Method

Abstract

THE AIM OF THE STUDY was comparison of inflammatory response intensity through estimation of CRP, IL-6 and WBC concentration in blood serum in patients before and after inguinal hernia operations with Stoppa and TEP method. MATERIAL AND METHODS. The study involoved 117 patients operated on inguinal hernia between 2006-2008. The patients were divided into two groups. In the first group (group I - 56) Stopp'a method was used, in the second (group II - 61) TEP method. The patients selection was coincidental. All examined patients were men between 25-75 years old (mean age 54.3). Moreover, the operation's time, state of postoperative wound, the average hospitalization time and intensity of pain were estimated. The observations were directed over two weeks after operation. RESULTS. The inflammatory response estimated with CRP, IL-6 concentration in blood serum was considerably higher in patients operated with Stoppa method. There wasn't observed a relevant difference in increase of white blood cells' concentration in both groups. Moreover, the patients operated on with TEP method experienced lower pain. In group, operated on with Stoppa method, 3 cases of wound healing complications were observed. The operation's time was considerably shorter in the first group. The hospitalization time, was considerably shorter in patients operated on with videoscopic method. CONCLUSIONS. The operation of inguinal hernia with TEP technique in comparison with Stopp'a method is connected with considerably lower inflammatory response of organism, what directly involve with postoperative pain abridgment and reduction of hospitalization time. Moreover it may have influence on frequency of postoperative complications related with wound healing.

<p>Cardioprotective effect of transcutaneous electrical acupuncture point stimulation on perioperative elderly patients with coronary heart disease: a prospective, randomized, controlled clinical trial</p>

“…Even minor postoperative cTnT elevation may increase morbidity and mortality in patients with myocardial injury 22–24. CRP is a non-specific biomarker of inflammation which has been described as a risk factor for cardiovascular disease 25. CK is an indicator that reflects the amplitude of operation injury in spinal surgery 26.…”

Abdominal adiposity is the main determinant of the C-reactive response to injury in subjects undergoing inguinal hernia repair

“…The C-reactive protein response to inguinal hernia repair has been described on numerous occasions, but with the goal of comparing operative technique rather than studying host characteristics which determine the inflammatory response [14]. Future studies in this area should take account of age and waist:hip ratio.…”

Dermatome mapping test (DMT) and it’s place on triple and selective neurectomy in patients with post-operative chronic inguinal pain

“…Los pacientes tratados con hernioplastias protésicas tienen mayor concentración sérica de PCR e IL-6 que los con solo herniorrafias, siendo mayor el nivel de marcadores en la cirugía abierta que en la videoasistida 87 . La técnica de Stoppa genera mayor respuesta inflamatoria que la TEP, y esta, con menor dolor posoperatorio y tiempo de hospitalización 88 . Sin embargo, esos resultados no son la norma en la bibliografía ni reflejan con suficiente nivel de evidencia la relación causa-efecto pretendida o esperada, es decir, que la cirugía videoasistida, como mínimamente invasiva que es, no se comporta como mínimamente agresiva, como señalan esos estudios comparativos entre la cirugía abierta y la videoasistida 89 , incluso cuando la hernioplastia abierta lleve o no una malla 90 .…”