A prospective trial of primary inguinal hernia repair by surgical trainees.
The main hypotheses were that the Lichtenstein inguinal hernia repair has a lower recurrence rate and similar incidence of chronic groin pain compared to sutured repairs when performed by surgical trainees. In a U.S. Veterans Administration Hospital, 150 primary hernia repairs were randomized to a Lichtenstein, McVay, or Shouldice repair. The Shouldice repair included a routine relaxing incision. First- and second-year residents, under the supervision of an experienced general surgeon, performed the procedure. Long-term follow-up was obtained in 81% of patients. Hernia recurrence rate was Lichtenstein 8%, McVay 10%, Shouldice 5% ( P>0.1) at 6-9 years follow-up. More patients had chronic groin pain following Lichtenstein repair (38%) than after Shouldice repair (7%) ( P<0.05). More information is needed on long-term groin pain following anterior mesh repair. The Shouldice inguinal hernia repair may have a role in open primary herniorrhaphy to decrease the risk of chronic groin pain.
Miedema
B W
BW
Department of Surgery, Harry S Truman Veterans Administration Hospital and the University of Missouri Health Center, Columbia, Missouri, USA. miedemab@health.missouri.edu
Ibrahim
S M
SM
Davis
B D
BD
Koivunen
D G
DG
D000328:Adult; D002908:Chronic Disease; D013505:Digestive System Surgical Procedures / Q000379:methods; D013502:General Surgery / Q000193:education; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D012008:Recurrence; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome