Summary: | 碩士 === 高雄醫學大學 === 醫務管理學研究所碩士在職專班 === 100 === Background
Inguinal hernia is a very common disease. The incidence is around 5-10% in the general population. Hernia will cause pain and affect the appearance. Also the incarcerated hernia may lead to intestinal necrosis and even death.In 1958, the polypropylene mesh was first used in hernia repair. Mesh repair is now standard in most countries and widely accepted as superior to tissue repair. As a result, there has been a rapid growth in the variety of meshes available and choosing the appropriate one can be difficult. The aim of this study is to compare different mesh in the repair of inguinal hernia with the efficiency analysis.
Materials and methods
This study was conducted over a period of one year from January 2008 to December 2008. A total of 338 cases suffering from inguinal hernia were divided into two group :(1)Light-Weight mesh group,175 cases (2)Heavy-weight mesh group,163 cases. We follow up the operation time, hospital stay, the cost of hospitalization, chronic pain, complications and recurrence rate.
Results
There has no significant difference in hospital stay, complications and recurrence rate. There has significant difference in operation time, chronic pain and cost of hospitalization. Heavy-weight mesh group need more operation time than light-weight mesh group(Heavy-weight mesh group :48.85 minutes, light-weight mesh group :38.67 minutes). In First post operative day, heavy-weight mesh group get more pain score than light-weight mesh group(Heavy-weight mesh group pain score :4.27 points, light-weight mesh group pain score :3.67 point).
In 3 months post operation, heavy-weight mesh group get more pain score than light-weight mesh group(Heavy-weight mesh group pain score :0.47 points, light-weight mesh group pain score :0.19 point). In 12 months post operation, heavy-weight mesh group get more pain score than light-weight mesh group(Heavy-weight mesh group pain score :0.22 points, light-weight mesh group pain score :0.07 point). Light-Weight mesh group spend more money in cost of hospitalization than heavy-weight mesh group(Heavy-weight mesh group cost :NT 28570.51 dollars, light-weight mesh group cost :NT 37317.29 dollars ).
Conclusions
In Taiwan, there are about 40,000 hernia repairs every year. The use of mesh repair has lower recurrence rate and lower complication rate than tissue repair. From our study, the light-weight mesh need less operation time than Heavy-weight mesh. The light-weight mesh group also has better result of chronic pain than heavy-weight mesh group. The results of this study can provide the reference to the bureau of health care policy and also to provide
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