Comparison of the posterior approach and anterior approach for a Kugel repair of treatment of inguinal hernias.
OBJECTIVE
The purpose of this study was to compare the outcomes following the posterior or anterior approach of Kugel repair for the surgical treatment of inguinal hernias.


METHODS
Patients with inguinal hernias who were treated using the original posterior approach (P group, n: 1262) and the anterior approach (A group, n: 1119) in China between 2003 and 2008 were evaluated retrospectively. The operation time, hospital stay, postoperative complications and recurrence after surgery were assessed and compared statistically in both groups.


RESULTS
The age, gender, types of hernia, operation time, hospital stay and the follow-up were comparable in the two groups. The operation time was 44.16 ± 12.66 min in the P group and 49.45 ± 14.34 min in the A group (P > 0.05). There were no significant differences in the incidence of hematoma, seroma and urinary retention, but the rate of incisional infection and severe pain in the A group were significantly lower than that in the P group (P < 0.05). The rate of recurrence differed significantly between the two groups with eleven in the P group (0.87 %) and one in the A group (0.09 %) (P < 0.05).


CONCLUSIONS
The lower rate of incisional infection, severe pain after surgery and much lower recurrence show the superiority of the anterior approach in comparison to the posterior approach for a Kugel repair of inguinal hernias.
Department of Surgery, Affiliated Dongguan Hospital, Guangzhou University of Chinese Medicine, 61 Dongmen Road, Dongguan, 523003 Guangdong, People's Republic of China. zhouxuelu@tom.com
Xuelu
X
Zhou
D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome