ABSTRACT
Objetivo: Determinar la incidencia de complicaciones tempranas y tardías según técnicas de Lichtenstein y Nyhus en el manejo de hernias inguinales en el Hospital Militar Central (HMC). Material y métodos: Transversalmente se analizaron todos los casos de hernia inguinal tratados quirúrgicamente en el HMC durante el período 2012-2014. Resultados: 202 casos (65%, varones) fueron analizados, de los cuales el 11% y el 89% fueron operados con las técnicas de Nyhus y Lichtenstein, respectivamente. Al comparar ambas técnicas no se encontraron diferencias en sus tiempos quirúrgicos (43,0±13,6 vs. 39,1±8,9 minutos; p=0,140), tiempos de hospitalización (3,9±1,2 vs. 3,8±0,8 días; p=0,635) e incidencia de complicaciones tardías (4% vs. 0%; p=0,603), pero sí al comparar la incidencia de complicaciones tempranas (17% vs. 0%; p=0.028). Las complicaciones tempranas y tardías más frecuentes fueron de tipo neuralgias (12% vs. 0%) y recurrencias (3% vs. 0%), respectivamente. Al análisis de regresión se encontró que tanto el tiempo quirúrgico (Odds ratio (OR); 1,07; Intervalo de confianza (IC) al 95%: 1,04-1,11) como el tiempo de hospitalización (OR: 1,55; IC 95%: 1,10-2,19) se encontraban significativamente asociados la ocurrencia de complicaciones tempranas. Conclusiones: En la experiencia del HMC ambas técnicas, Lichtenstein y Nyhus, demostraron ser alternativas seguras en el manejo quirúrgico de hernias inguinales, siendo las complicaciones tempranas más frecuentes con la técnica de Lichtenstein y, en ambos casos, más frecuentes mientras mayor el tiempo quirúrgico y el tiempo de hospitalización
Objective: To determine the frequency of early and late complications using the Lichtenstein and Nyhus techniques for the management of inguinal hernias in the Peruvian Military Central Hospital. Material and methods: A cross-sectional study was performed, in which we analyzed the all gases of inguinal hernia that underwent surgical repair during the 2012-2014 period. Results: Two hundred and two cases were analyzed (65% from male subjects), of which 11% and 89% were operated using the Nyhus and Lichtenstein techniques, respectively. When comparing both techniques, no differences were found in terms of surgical time (43.0 ± 13.6 vs. 39.1 ± 8.9 minutes; p= 0.140), hospitalization duration (3.9 ± 1.2 vs. 3.8 ± 0.8 days; p= 0.635), and late complications (4% vs. 0%; p= 0.603), but we found significant differences in the frequency of early complications (17% vs. 0%; p= 0.028). The most frequent early and late complications were neuralgia (12% vs. 0%) and recurrence (3% vs. 0%), respectively. Using the logistic regression analysis we found that both the operating time (odds ratio (OR): 1.07; 95% confidence interval (CI): 1.04-1.11) and the length of hospitalization (OR: 1.55; 95% CI: 1.10-2.19), were significantly associated with the occurrence of early complications. Conclusions: In the experience of the Peruvian Military Central Hospital both Lichtenstein and Nyhus techniques proved to be quite safe for the surgical management of inguinal hernias. Early complications were more frequently observed with the Lichtenstein technique; and, with both techniques, complications were more frequent with longer surgical times and prolonged hospitalization times