2003, Number 4
Inguinal hernioplasty: A comparison of tension and tension-free techniques prospective and randomized study in the Hospital General de Mexico
Elizalde MA, Chapa AO, Garza FJH, Mauricio HL, Elizalde ÁN, Escalante TT
Full text
Language: Spanish
References: 17
Page: 204-209
PDF size: 60.37 Kb.
ABSTRACT
Background: Currently, the most successful anterior techniques for inguinal hernia repair are the Shouldice technique (“tension” repair), the Lichtenstein procedure, and the Rutkow repair (both of which require a polypropylene mesh). We are seeking the most suitable technique for the Mexican patient. Materials and methods: We conducted a longitudinal, prospective, randomized clinical trial, on patients diagnosed with inguinal hernias that attend Mexico’s General Hospital. The independent variable was the surgical repair technique, either the Shouldice procedure, the Lichtenstein repair, or the Rutkow technique. The dependent variables were operative complications, total surgical time, postoperative complications, time elapsed to recover physical activity, time to recover full-work activity, and hernia recurrence. Results: We operated 100 patients with inguinal hernia. The Shouldice procedure was performed on 37 patients, the Lichtenstein repair was performed on 32 patients, and the Rutkow technique was performed on 31 patients. Total operative time was 70 minutes for the Shouldice repair, 58 minutes for the Lichtenstein repair, and 57 minutes for the Rutkow repair. Five patients suffered operative complications: 3 patients received general anesthesia because of incomplete regional anesthesia, and 2 patients had adverse reactions to the prophylactic antibiotic. Postoperative complications included acute urinary retention in 2 patients, postoperative neuralgia in 5 patients, hydrocele in 2 patients, and one patient suffred presented with a hematoma. In average, pain lasted 4.18 days in the Shouldice procedure group, 2.3 days in the Lichtenstein repair group, and 2.2 days in the Rutkow technique group. Time to recover physical activity was 6.5 days for the Shouldice repair group, 3.3 days for the Lichtenstein technique group, and 2.2 days for the Rutkow procedure group. Time to recover full-work activity was 16.2 days for the Shouldice repair group, 13.6 for the Lichtenstein technique group, and 9.4 days for the Rutkow procedure group. Postoperative follow-up is currently 90% at 12 months. Conclusion: Our preliminary results show a tendency for less pain and faster recovery with the use of polypropylene mesh for inguinal hernia repair. Final results, including statistical analysis, are yet to come.REFERENCES