Kugel Fıtık Tamiri Gerçekten Minimal İnvaziv midir?: Prospektif Randomize Bir Çalışma
Amaç: Kugel fıtık tamirinin minimal invaziv bir teknik olduğu ileri sürülmektedir. Bu çalışmanın amacı Kugel ve Lichtenstein girişimlerinden sonra gelişen enflamatuvar yanıtları ve klinik sonuçları karşılaştırmaktı. Hastalar ve Metotlar: Tek taraflı kasık fıtığı olan 30 hasta Kugel ve Lichtenstein tamir gruplarına rastgele ayrıldılar. Cerrahi girişimden hemen önce ve girişimden sonraki 12. ve 48. saatlerde, interlökin-6 ve C-reaktif protein seviyelerini ölçmek için periferik venöz kan örnekleri alındı. Cerrahi sonrası akut ve kronik ağrı değerlendirildi. Normal aktivitelere ve işe dönüş süreleri kaydedildi. Bulgular: Lichtenstein girişiminden sonra interlökin-6 düzeyleri belirgin olarak artarken Kugel fıtık tamiri, interlökin-6 düzeylerinde anlamlı olmayan bir artışa neden oldu. C-reaktif protein düzeyleri her iki grupta da belirgin olarak arttı. Kugel girişiminden sonra hastaların ağrısı daha azdı ve daha erken iyileştiler. Sonuç: Sonuçlarımız göstermektedir ki, Kugel fıtık tamiri Lichtenstein tekniği ile karşılaştırıldığında daha az enflamatuvar yanıta, daha az ameliyat sonrası ağrıya ve daha hızlı iyileşmeye neden olmaktadır. Anahtar kelimeler: Kugel fıtık tamiri, Lichtenstein ameliyatı, Enflamatuvar yanıt, Minimal invaziv
Is Kugel Herniorraphy Really Minimally Invasive?: A Prospective, Randomized Study+
Background: Kugel herniorraphy had been advocated as a minimally invasive technique. The purpose of this study was to compare inflammatory responses and clinical outcomes after Kugel and Lichtenstein procedures. Patients and methods: Thirty patients with unilateral inguinal hernia were randomized into Kugel and Lichtenstein repair groups. Peripheral venous blood samples were collected, to measure the levels of interleukin-6 and C-reactive protein, just prior to surgery and then 12 and 48 hours postoperatively. Postoperative acute and chronic pains were evaluated. Time to return normal activities and work was recorded. Results: Interleukin-6 levels significantly increased after Lichtenstein procedure. C-reactive protein levels were significantly increased in both groups. Patients had less postoperative pain and they recovered earlier after the Kugel procedure. Conclusions:In conclusion our data show that Kugel herniorraphy causes less inflammatory response, less postoperative acute pain and rapid recovery compared with Lichtenstein technique. Key words: Kugel herniorraphy, Lichtenstein procedure, Inflammatory response, Minimally invasive
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