Management of strangulated inguinal hernias: a comparison of the Désarda versus Bassini procedure

Bray Madoué Kaimba; Seid Dounia Akouya; Kader Ndiaye; Allassyengar Ndormadjita

doi:10.18203/2349-2902.isj20263332

Authors

Bray Madoué Kaimba Department of Surgery, Center Hospitalier University La Renaissance de Ndjamena, Chad; University of Ndjamena-Ndjamena, Chad
Seid Dounia Akouya Department of Surgery, Center Hospitalier University La Renaissance de Ndjamena, Chad
Kader Ndiaye Department of Anesthesiology, Center Hospitalier University La Renaissance de Ndjamena, Chad
Allassyengar Ndormadjita Department of Surgery, Center Hospitalier University La Renaissance de Ndjamena, Chad; University of Ndjamena-Ndjamena, Chad

DOI:

https://doi.org/10.18203/2349-2902.isj20263332

Keywords:

Strangulated hernia, Desarda, Surgical emergency, Recurrence, Chronic postoperative pain

Abstract

Background: The unsatisfactory results of suture repair (high incidence of recurrence and chronic postoperative pain) mean that practitioners are constantly seeking techniques that offer the best outcomes. Consequently, the Désarda technique warrants testing in the management of strangulated inguinal hernias. The aim of this study was to compare the Désarda technique with tissue raphia (Bassini) in the treatment of strangulated inguinal hernias

Methods: This was a prospective, randomised, single-centre, controlled study conducted from December 2013 to December 2019 at the La Renaissance University Hospital Centre in N’Djamena.

Results: A total of 133 patients were recruited, comprising 109 men and 24 women, with a mean age of 29.5 years±5 years and a range of 18 to 61 years. There were no intraoperative or early postoperative complications in either group. Nor were there any deaths. The 7-year recurrence rate was significantly lower in the Désarda group (1.8% vs 12.2%; the odds ratio was 0.07 with a 95% confidence interval ranging from 0.01 to 0.55), p=0.02. The result is statistically significant because p<0.05. The risk of developing chronic post-operative pain was one-tenth as high in the Desarda group compared with the Raphie group. The odds ratio was 0.1 with a 95% confidence interval ranging from (0.01 to 0.8). The Desarda procedure statistically significantly reduces the rate of dissatisfaction among patients who have undergone surgery. The odds ratio was 0.07, with a 95% confidence interval ranging from 0.01 to 0.55; this association was statistically significant.

Conclusions: The Desarda technique is a safe and effective method as it reduces the incidence of recurrence and postoperative pain. The majority of patients who underwent surgery were satisfied.

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