Comparative study between lichtenstein patch hernioplasty versus tailored plug and patch hernioplasty as a treatment of inguinal hernia

Abstract EN

Background : Hernia repair is currently the most commonly performed general surgical operation, it occurs with a greater frequency in men than women (12 : 1 ratio).

Repair of groin hernias has evolved from primary tissue repairs, which have a great tendency of recurrence rate and tension free repair with low rate of recurrence and less pain.

Open mesh used in anterior inguinal hernia repair can be configured as a flat patch (Lichtenstein operation) or as a cone-shaped preformed plug and supplementary patch (plug-and-patch operation) ; which can be tailored manually from a flat sheet.

Aim : We compare between Lichtenstein patch hernioplarty and tailored plug and patch hernioplarty to find out which of them is easier to apply, learn and teach.

Also to know of any of the two methods is risky Methods Forty patients were randomly allocated and blinded to receive either a Lichtenstein patch or a plug-and-patch.

Information before the operation and on postoperative days 3 and 14 was recorded by an independent blinded observer to include operating time, postoperative pain, analgesic medication, return to activity and work, and quality of life assessment.

Follow up for two years for recurrence.

Results Operating time (median = 38 vs 43 minutes) was insignificantly shorter in the plug-and-patch group (P = .107).

During days 1 through 8, Patients who had undergone the plug-and-patch operation experienced less pain, and their physical functioning on day 3 was significantly better (P= .000).

Days of analgesic medication (median = 2 vs 6 days), return to normal activity (median = 2.5 vs 3.5 days), return to work (12.0 vs 14.5 days).no recurrence rate after two years follow up for both groups.

Conclusions :- Compared with patients who received the Lichtenstein patch for ambulatory inguinal hernia repair, patients who underwent the tailored plug-and-patch operation experienced less postoperative pain in the first 8 days after the operation but consumed similar postoperative analgesic medication.

The rate of return to normal activity and work is similar in both groups, which indicates no superiority for the plug-and patch operation in overall rehabilitation.

Overall hospital costs are greater for the plug-and-patch operation compared with the Lichtenstein patch, with a negligible (5.0) saving of operating room time for the plug-and patch operation.

There is no recurrence rate after 1.7 Ys follow up for both groups.