| Subject |
Comparative Study Between Lichtenstein Patch Hernioplasty Versus Tailored Plug and Patch Hernioplasty as A Treatment of Inguinal Hernia |
| Authors |
Saad A., Gaber M., Metawe A., Fathy M. |
| Code |
2010 -
vol. 31,
No. 1,
Page. 24
|
| Type |
Research Article
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| FILE #1 : 24-30_.pdf (188.7K), Down:4626, 2011-09-12 03:22:47 |
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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-andpatch
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-andpatch
operation. There is no recurrence rate after 1.7 Ys follow up for both
groups.
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