Lichtenstein Versus Desarda Technique for Inguinal Hernia Repair: A Randomized Clinical Trial
Habib Ahmed, Muhammad Tariq Nazir, Fakhar Irfan, Mudassar Murtaza, Ashfaq Nasir Khan
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ABSTRACT
Background: There are different techniques for the repair of inguinal hernia, whichcan
be classified broadly intothe techniques usingprosthetic mesh andtissue-based techniques.
The recent guidelines recommend the mesh repair as first choice, either by laparo-endoscopic
technique or an open procedure.The Desarda’s operation
is tissue based repair with comparable results to open mesh repair.
Aim: To compare the
results of Lichtenstein mesh repair (L group) with Desarda’s technique (D
group).
Methods: 100
adult male patients with uncomplicated inguinal hernias were included; 50 in
each group. Patients with intra operative finding of
weak, thin or split fibers external oblique aponeurosis were excluded. The patients were followed in terms of postoperative
and chronic pain, time taken to start basic activities and work, recurrence of
hernia and other complications.
Results:Operating
time was comparable in both groups. 6% patients in L group and 4% in D group had mild to
moderate groin pain within 30 days. It resolved in all patients except in one
patient in L group, who had chronic mild groin pain. Patients in D group took
less time to return to basic activities and work than patients in L
group. 4% patients in L
group and 2% in D group had surgical site infection. Scrotal edemaoccurred in
6% in L group 4% in D group and it resolved in all patients in both groups
within 30 days. 6% in L group and 8% in D group suffered wound hematoma; out of
these only 1 patient (2%) in L groupneeded operative drainage. Wound seroma
occurred in 6% in L group and 2 % in D group; out of these 1 patient needed
aspiration once in L group; others resolved spontaneously. There was no
recurrence of hernia in both groups in our study.
Conclusion:Inguinal hernia can be treated successfully without
mesh by Desarda repair technique. Its recurrence rates are comparable to
the standard Lichtenstein mesh repair with less complications. However,
intraoperative finding of weak, thin, or splitfibers of external oblique aponeurosis is the basic hindrance in Desarda technique.
Keywords: Inguinal hernia, Lichtenstein, Desarda
ABSTRACT
Background: There are different techniques for the repair of inguinal hernia, whichcan
be classified broadly intothe techniques usingprosthetic mesh andtissue-based techniques.
The recent guidelines recommend the mesh repair as first choice, either by laparo-endoscopic
technique or an open procedure.The Desarda’s operation
is tissue based repair with comparable results to open mesh repair.
Aim: To compare the
results of Lichtenstein mesh repair (L group) with Desarda’s technique (D
group).
Methods: 100
adult male patients with uncomplicated inguinal hernias were included; 50 in
each group. Patients with intra operative finding of
weak, thin or split fibers external oblique aponeurosis were excluded. The patients were followed in terms of postoperative
and chronic pain, time taken to start basic activities and work, recurrence of
hernia and other complications.
Results:Operating
time was comparable in both groups. 6% patients in L group and 4% in D group had mild to
moderate groin pain within 30 days. It resolved in all patients except in one
patient in L group, who had chronic mild groin pain. Patients in D group took
less time to return to basic activities and work than patients in L
group. 4% patients in L
group and 2% in D group had surgical site infection. Scrotal edemaoccurred in
6% in L group 4% in D group and it resolved in all patients in both groups
within 30 days. 6% in L group and 8% in D group suffered wound hematoma; out of
these only 1 patient (2%) in L groupneeded operative drainage. Wound seroma
occurred in 6% in L group and 2 % in D group; out of these 1 patient needed
aspiration once in L group; others resolved spontaneously. There was no
recurrence of hernia in both groups in our study.
Conclusion:Inguinal hernia can be treated successfully without
mesh by Desarda repair technique. Its recurrence rates are comparable to
the standard Lichtenstein mesh repair with less complications. However,
intraoperative finding of weak, thin, or splitfibers of external oblique aponeurosis is the basic hindrance in Desarda technique.