The tension-free hernioplasty in a randomized trial.
BACKGROUND
The tension-free hernioplasty as introduced by Lichtenstein has gained increasing acceptance during the last decade although the technique has not been evaluated in a randomized trial.


METHODS
This randomized study compares the 2-year follow-up results after 102 tension-free hernioplasties with implantation of a prolene mesh in all groin hernias to 53 Cooper ligament repairs in direct hernias and 53 abdominal ring repairs in indirect hernias.


RESULTS
After tension-free repairs five hernias recurred (5%), and after either Cooper ligament or abdominal ring repair, 16 recurrences were found (15%) (P = 0.025). No indirect hernias recurred after a tension-free repair; 2 recurred after abdominal ring repair (4%; NS). The recurrence rate after tension-free repairs for primary direct inguinal hernias was 7% as compared with 30% after Cooper ligament repair (P = 0.0081). No difference in complication rate between the tested methods was found.


CONCLUSIONS
Recurrence rate is reduced to one-third after tension-free herniotomies as compared with the conventionel herniotomies without increase in complication rate.
Friis
E
E
Department of Surgical Gastroenteroenterology K, Bispebjerg Hospital, University of Copenhagen, Denmark.
Lindahl
F
F
D000041:Absenteeism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008022:Ligaments / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011183:Postoperative Complications; D012008:Recurrence; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000209:etiology