title: Inguinal hernia repair with the dynamic self-regulating prosthesis (PAD system). Recurrence and complications in 236 consecutive patients.
abstract: We retrospectively analysed 236 consecutive patients with primary and recurrent inguinal hernia treated with the dynamic self-regulating prosthesis (PAD system). Parameters such as hernia type, operation time, type of anaesthesia, complications, hospital stay and recurrence were evaluated. Recurrence rates were determined by clinical examination. 254 PAD procedures were performed on 236 adult male patients. Inguinal hernias were unilateral in 218 patients, bilateral in 18 patients, and recurrent in 22 patients. There were 101 patients (43%) with Nyhus type II hernia, 113 (48%) with Nyhus type III hernia, and 22 (9%) with Nyhus type IV hernia; local anaesthesia was used in 149 (63%) patients, and epidural anaesthesia in the others. Haemorrhage occurred in 2 patients (0.8%) and required re-operation. After a median follow-up of 40 months (range: 21-56), there were only 2 (0.8%) recurrences, both in the same patient. Persistent inguinal pain at 1 year occurred in 3 patients (1.2%). There was no statistical correlation between preoperative comorbid disease, Nyhus type of hernia, operative time and recurrence (p < 0.2). We conclude that the PAD system is as effective as mesh repair with an acceptable recurrence rate and fewer complications.
authors.affiliation: Dipartimento di Chirurgia Generale e Vascolare, Clinica Sant'Elena, Quartu Sant'Elena, Cagliari.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Tuveri
authors.forename: Pietro Giorgio
authors.initials: PG
authors.lastname: Calò
authors.forename: Valentina
authors.initials: V
authors.lastname: Borsezio
authors.forename: Giorgia
authors.initials: G
authors.lastname: Melis
authors.forename: Fabio
authors.initials: F
authors.lastname: Medas
authors.forename: Augusto
authors.initials: A
authors.lastname: Tuveri
authors.forename: Angelo
authors.initials: A
authors.lastname: Nicolosi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000145:classification / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D019736:Prostheses and Implants / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome