Tension-free hernia repair is associated with an increase in inflammatory response markers against the mesh.
BACKGROUND
The purpose of this study was to evaluate the involvement of inflammatory mediators in patients undergoing Lichtenstein tension-free hernioplasty (LH) using polypropylene prosthetic materials or conventional Bassini hernia repair (BH).


METHODS
Thirty patients male with unilateral inguinal hernia without complications or recurrence were included in this study. Randomly, patients underwent LH or BH. Peripheral venous bloods samples were collected 24 hours prior to surgery and then 6, 24, 48 and 168 hours postoperatively.


RESULTS
We present evidences that LH patients showed a higher increased serum level of fibrinogen, C-reactive protein, alpha-1-antitrypsin, and interleukin-6 than BH patients. Postoperative visual analogue scales for pain were reduced on mobilization for patients undergoing LH compared with BH. Neutrophils were significantly increased only in LH compared with baseline. Ceruloplasmin, transferrin, and albumin levels were unmodified after BH or LH.


CONCLUSIONS
In conclusion our data show that although LH induces less pain and more rapid postoperative recovery, it is associated with an higher inflammatory response compared with BH, likely due to polypropylene mesh.
Di Vita
G
G
Department of Surgery, 2nd Division, University of Palermo, Palermo, Italy.
Milano
S
S
Frazzetta
M
M
Patti
R
R
Palazzolo
V
V
Barbera
C
C
Ferlazzo
V
V
Leo
P
P
Cillari
E
E
D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D005549:Foreign-Body Reaction / Q000097:blood / Q000209:etiology; D006552:Hernia, Inguinal / Q000276:immunology / Q000601:surgery*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000209:etiology* / Q000276:immunology; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes / Q000009:adverse effects*; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology* / Q000276:immunology; D011184:Postoperative Period; D019919:Prosthesis Implantation / Q000009:adverse effects*; D013526:Surgical Mesh / Q000009:adverse effects*; D000515:alpha 1-Antitrypsin / Q000378:metabolism
D015850:Interleukin-6; D011126:Polypropylenes; D000515:alpha 1-Antitrypsin; D005340:Fibrinogen; D002097:C-Reactive Protein