A comparison of Lichtenstein repair versus posterior wall repair plus mesh repair for direct inguinal hernias

Authors

  • Anubhav Goel Department of Surgery, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India
  • Ankur Bansal Department of Surgery, S. R. Hospital, Agra, Uttar Pradesh, India
  • Dipt Kumar Department of Surgery, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India
  • Abhishek Pathak Department of Surgery, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20175900

Keywords:

Hernia, Lichtenstein, Mesh repair

Abstract

Background: Lichtenstein’s tension free mesh repair is the most commonly performed in open inguinal hernias. The present study was done by comparing Lichtenstein Repair (LR) v/s posterior wall repair (PR)+ Lichtenstein repair (LR) of direct Inguinal Hernias to compare the technique of both surgeries and its outcome like postoperative complications and recurrence rate.

Methods: This study was conducted in SNMC Agra where patients of unilateral male direct inguinal hernia were included. A total of 60 patients were taken and divided into two groups (A and B) randomly of 30 each. In group A patients were operated by LR and in group B patients were operated by PR+LR and followed up for a period of six months. The outcomes of the both techniques were compared.

Results: Mean age was 48.3 years in group A and 49.5 in group B. The mean duration of surgery for group A is around 29.34 min and group B is 46.28 min which was significant. The pain was not statistically significant in both groups on day 1 and 3. There was 1 (3.3%) recurrence in group A and no recurrence in group B. Post-operative complications were similar in both groups.

Conclusions: LR+PR were comparatively better than only LR in all direct inguinal hernias because of low recurrence rate (0%).

References

Ebbell B. The ebers papyrus. The greatest egyptian medical document. London: H. Milford and Oxford University Press;1937:123.

Daniel J, Daniel BJ. Surgery. Basic Science and Clinical Evidence. 2008;2:1133.

Bruce J. Forward. In: Nyhus LM, Harkins HN, eds. Hernia. 1st ed. Philadelphia: Lippincott;1964.

Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet. 2003;362:1561-71.

Cervantes J. Inguinal Hernia in the New Millennium. World J Surg. 2004;28:343-7.

Cheong KX, Lo HY, Neo JX, Appasamy V, Chiu MT. Inguinal hernia repair: are the results from a general hospital comparable to those from dedicated hernia centres? Singapore Med J. 2014;55(4):191-7.

Harjai Lt Col MM, Nagpal Brig BM, et al. A Prospective randomized controlled study of Lichtenstein’s tension free versus modified bassini repair in the management of groin hernias. MJAFI. 2007;63:40-3.

R. Bittner and J. Schwarz. Inguinal hernia repair: current surgical techniques. Langenbeck's Arch Surg. 2012;397(2):271-82.

Bay-Nielsen M, Kehlet H, Strand L, Malmstrøm J, Andersen FH, Wara P, et al. Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet. 2001;358:1124-8.

Jansen PL, Klinge U, Jansen M, Junge K. Risk factors for early recurrence after inguinal hernia repair. BMC Surg. 2009;9:18.

Hetzer FH, Hotz T, Steinke W, Schlumpf R, Decurtins M, Largiader F. Gold standard for inguinal hernia repair: Shouldice or Lichtenstein?. Hernia. 1999 Sep;3(3):117-20.

Shyam DC, Rapsang AG. Inguinal hernias in patients of 50 years and above. Pattern and outcome. Rev Col Bras Cir. 2013;40(5):374-9.

Kark AE, Kurzer M, Waters KJ. Tension-Free mesh hernia repair. Reviev of 1098 cases using local anaesthesia in day unit. Annal Royal Coll Surg England. 1995;77(4):299-304.

Bellone D, Sacco D, Spidalieri G, Cardiono L. Tension-free hernioplasty. Minerva Chirurgica. 1999;54(3):123-5.

McGillicuddy JE. Prospective randomized comparison of the Shouldice and Lichtenstein hernia repair procedures. Arch Surg. 1998;133(9):974-8.

Köninger JS, Oster M, Butters M. Management of inguinal hernia. Chirurgie. 1998;69(12):1340-4.

Wantz GE. My experience in repairing, without tension, primary inguinal hernia in men. Chirurgie. 1997;122(2):111-6.

Aasvang E, Kehlet H. Chronic postoperative pain: the case of inguial herniorrhaphy. Br J Anaesth. 2005;95:69-76.

O’Dwyer PJ, Serpell MG, Millar K, Paterson C, Young D, Hair A et al. Local or general anaesthesia for open hernia repair: a randomized trial. Ann Surg. 2003;237:574-9.

Jenkins JT, O Dwyer PJ. Inguinal hernias. BMJ. 2008;336:269-72.

Finley RK, Miller SF, Jones LM. Elimination of urinary retention following inguinal herniorrhaphy. Am Surg. 1991;57:486-8.

Fitzgibbons RJ. Can we be sure that polypropylene mesh causes infertility? Ann Surg. 2005;241:559-61.

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Published

2017-12-26

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Original Research Articles