Femoral vessel blood flow dynamics following totally extraperitoneal vs Stoppa procedure in bilateral inguinal hernias

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• 作者：Mahir Ozmen ; Baris Zulfikaroglu ; Necdet Ozalp ; Munevver Moran ; Perihan Soydinc ; Ipek Ziraman
• 关键词：Laparoscopy ; Hernia repair ; Prosthetic mesh ; Preperitoneal ; TEP ; Stoppa ; Femoral vessels ; Doppler ultrasound
• 刊名：The American Journal of Surgery
• 出版年：2010
• 出版时间：June 2010
• 年：2010
• 卷：199
• 期：6
• 页码：741-745
• 全文大小：159 K

文摘

Background

Both totally extraperitoneal (TEP) and open preperitoneal (Stoppa) procedures involve the placement of prosthetic material preperitoneally. Because the prosthetic material overlies the femoral artery and vein, the aim of this study was to assess its effect on the velocities and diameters of the artery and vein using color Doppler ultrasonography in both approaches.

Methods

Sixty-four patients with bilateral groin hernias were prospectively randomized to undergo either TEP (n = 32) or Stoppa (n = 32) repair. All patients underwent color Doppler ultrasound 6 months after the procedures, and the median follow-up period was 18 months.

Results

Neither mean diameter nor mean flow velocity was changed by the insertion of the mesh preperitoneally. The only change was observed in peak systolic femoral arterial blood velocity, which was significantly decreased in the Stoppa group. Also, no patient in this study developed clinically significant deep venous thrombosis during 6 months of follow-up.

Conclusions

The insertion of a prosthetic mesh during TEP and Stoppa procedures does not influence the mean peak flow velocities and cross-sectional areas of the vessels in the inguinal region and can be used safely for open and laparoscopic preperitoneal approaches.