[Treatment of inguinal hernia in the adult: results of tension-free procedures].
OBJECTIVE
The aim of this study was to verify, by a prospective multicenter evaluation, if the results attributed to tension-free procedures were obtained in current practice.


METHODS
From 1994 to 1997, 398 patients were operated on by three surgical teams. There were 357 men and 4 women (mean age: 58.5 years, range: 25-90). The hernia was bilateral in 37 patients and 435 hernias were treated by Perfix plug (n = 322), Gilbert plug (n = 76) or by Lichtenstein procedure (n = 37), according to the choice of the surgeon. In tension-free procedures, sutures under tension were replaced by a mesh or a plug without any approximation of the margins of the hernial orifice. The procedure was performed under local (n = 316), epidural (n = 94), or general (n = 25) anesthesia.


RESULTS
There were no postoperative deaths. There were 19 postoperative benign complications (4.4%). The duration of analgesics consumption, postoperative hospital stay, cessation of normal activities and work (mean [SD] [range]) were 3.3 days ([3.9] [0-60]), 1.3 day ([1.1] [0-16]), 4.5 days ([3.1] [0-34]) and 15.4 days ([10.2] [0-60]) respectively. With a mean follow-up of 36 months ([14] [6-67]), 423 hernias (97.2%) were assessed. Two (0.5%) recurrences occurred. Twenty three patients had secondarily troubles (5.8%): 21 patients complained of chronic pain, one had testis atrophy and one plug had to be removed.


CONCLUSIONS
These results confirm that tension-free procedures are minimally invasive, induce few benign postoperative complications and low pain, allow early return to normal activity, and are followed by few recurrences.
Marre
P
P
Centre de chirurgie herniaire de Paris-La Défense, 2-14, rue Paul-Napoléon-Roinard, 92400 Courbevoie, France.
Damas
J M
JM
Penchet
A
A
Pélissier
E P
EP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006552:Hernia, Inguinal / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome