The evaluation of the peak flow velocity and cross-sectional area of the femoral artery and vein following totally extraperitoneal vs preperitoneal open repair of inguinal hernias.
BACKGROUND
Both totally extraperitoneal (TEP) and preperitoneal (PPOR) approaches involve the placement of prosthetic material preperitoneally. As the prosthetic material overlies the femoral artery and vein, we aimed to assess its effect on the velocity and the diameter of the artery and vein, using colour Doppler ultrasonography in both approaches.


METHODS
Eighty patients with unilateral groin hernia were prospectively randomised to have either TEP repair (n = 40) or PPOR (n = 40). All patients underwent colour Doppler ultrasound study 6 months after the procedure, and all patients were followed up for 5 years to evaluate real recurrence rates.


RESULTS
Our study revealed that neither mean diameter nor mean flow velocity is changed by the insertion of the mesh preperitoneally. Change was only observed in the peak systolic femoral arterial blood velocity, which was significantly decreased in the PPOR group. We also found that no patient in this study developed a clinically significant deep-vein thrombosis during 6 months of follow-up.


CONCLUSIONS
It is concluded that the insertion of a prosthetic mesh during TEP or PPOR does not influence the mean peak flow velocity and the cross-sectional area of the vessels in the inguinal region and can be used safely for open and laparoscopic preperitoneal approaches.
Ozmen
M M
MM
Department of Surgery, Ankara Numune Teaching and Research Hospital, 06100 Ankara, Turkey. mmahir@mynet.com
Ozalp
N
N
Zulfikaroglu
B
B
Soydinc
P
P
Ziraman
I
I
Hengirmen
S
S
D000328:Adult; D000368:Aged; D019412:Anatomy, Cross-Sectional; D001783:Blood Flow Velocity; D004452:Echocardiography; D005260:Female; D005263:Femoral Artery; D005268:Femoral Vein; D005355:Fibrosis / Q000209:etiology / Q000503:physiopathology; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D013526:Surgical Mesh / Q000009:adverse effects*; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D018615:Ultrasonography, Doppler, Color; D014945:Wound Healing / Q000502:physiology