Randomized controlled trial comparing prolene hernia system and lichtenstein method for inguinal hernia repair.
BACKGROUND
There are no data regarding the long-term outcomes of prolene hernia system (PHS) mesh in the published reports. The aim of the study was to compare the short-term and long-term outcomes of the PHS mesh with the Lichtenstein mesh technique.


METHODS
Sixty-four patients with inguinal hernia were randomized to undergo either a PHS or a Lichtenstein repair under local anaesthesia as a day case. Early outcome measures were duration of surgery, pain scores, analgesic requirements, time to return to work, driving and full activity. Long-term outcome measures were chronic groin pain and recurrence.


RESULTS
Mean duration of surgery in the PHS group was 36 min (SD +/- 11) versus 34 min in the Lichtenstein group (SD +/- 8; P = 0.3). There was no significant difference in analgesic requirements (P = 0.65). Overall mean pain score was 3.5/10 versus 2.5/10 (P = 0.1). Mean time to return to work was 42 versus 30 days (P = 0.3), returning to driving was 20 versus 14 days (P = 0.2) and full activity was 21 versus 22 days (P = 0.8). Chronic groin pain developed in four patients in the PHS group (12.9%) and in five patients in the Lichtenstein group (15.1%; P > 0.05). One patient developed recurrent herniation in the PHS group. The median follow up was 4.2 years (range, 4-4.6 years). Patient satisfaction was very high with both the techniques.


CONCLUSIONS
There is no significant difference in the early and long-term outcomes between PHS and Lichtenstein hernia repairs. The PHS technique involving preperitoneal dissection is well tolerated and easy to carry out under local anaesthesia.
Sanjay
Pandanaboyana
P
Department of Surgery, Royal Glamorgan Hospital, Llantrisant, UK.
Harris
Dean
D
Jones
Philippa
P
Woodward
Alan
A
D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011126:Polypropylenes; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods*; D013526:Surgical Mesh; D013997:Time Factors; D016896:Treatment Outcome
D011126:Polypropylenes