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News

Comparing 3 methods for open inguinal hernia repair

Results show that there is no clinically significant difference in postoperative pain and quality of life between the 3 types of mesh hernia repair: mesh plug repair, Prolene® Hernia System and the Lichtenstein method.

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Most surgeons favor the use of a mesh for open inguinal hernia repair as it has a low recurrence rate.

Procedures used most frequently are the Lichtenstein method, mesh plug repair and the Prolene® Hernia System.

The choice of technique may be influenced by the effects on postoperative pain and quality of life.

Dr Nienhuijs and colleagues undertook a study of 334 patients who were allocated blindly and at random to receive one of these 3 meshes for open hernia repair.

The researchers assessed quality of life with the Short Form 36 and pain by a visual analogue scale 14 days, and 3 and 15 months after surgery.

The researchers noted that operative complications were rare and comparable between the groups.

No significant differences in pain parameters between the 3 meshes; 43% of patients reported groin pain
British Journal of Surgery

The research team completed long-term follow-up using a questionnaire filled out by 96% of patients.

The researchers found that there were no significant differences in pain parameters between the 3 meshes; overall, 43% of patients reported some form of groin pain.

The severity of the chronic pain correlated with a higher pain score in the first 2 weeks after surgery.

The research team observed that a significant reduction in scores for role emotional (short term) and vitality (long term) quality of life domains was found in patients who had a Lichtenstein repair.

Dr Nienhujis commented, "These short- and long-term results did not show any clinically significant difference in postoperative pain and quality of life between the three types of mesh hernia repair."

"Severe early postoperative pain reliably predicted the likelihood of persisting chronic groin pain."

British Journal of Surgery; 2005: 92 (1): 33-38
12 January 2005

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