title: Randomized clinical trial of self-gripping mesh versus sutured mesh for Lichtenstein hernia repair.
abstract: BACKGROUND
  Many patients develop discomfort after open repair of a groin hernia. It was hypothesized that suture fixation of the mesh is a cause of these symptoms.
  
  
  METHODS
  This patient- and assessor-blinded randomized multicentre clinical trial compared a self-gripping mesh (Parietene Progrip(®)) and sutured mesh for open primary repair of uncomplicated inguinal hernia by the Lichtenstein technique. Patients were assessed before surgery, on the day of operation, and at 1 and 12 months after surgery. The primary endpoint was moderate or severe symptoms after 12 months, including a combination of chronic pain, numbness and discomfort.
  
  
  RESULTS
  The intention-to-treat population comprised 163 patients with self-gripping mesh and 171 with sutured mesh. The 12-month prevalence of moderate or severe symptoms was 17·4 and 20·2 per cent respectively (P = 0·573). There were no significant differences between the groups in postoperative complications (33·7 versus 40·4 per cent; P = 0·215), rate of recurrent hernia within 1 year (1·2 per cent in both groups) or quality of life.
  
  
  CONCLUSIONS
  The avoidance of suture fixation using a self-gripping mesh was not accompanied by a reduction in chronic symptoms after inguinal hernia repair.
  
  
  BACKGROUND
  NCT00815698 (http://www.clinicaltrials.gov).
authors.affiliation: Department of Surgery, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark. larsnjorgensen@hotmail.com
authors.forename: L N
authors.initials: LN
authors.lastname: Jorgensen
authors.forename: T
authors.initials: T
authors.lastname: Sommer
authors.forename: S
authors.initials: S
authors.lastname: Assaadzadeh
authors.forename: L
authors.initials: L
authors.lastname: Strand
authors.forename: A
authors.initials: A
authors.lastname: Dorfelt
authors.forename: M
authors.initials: M
authors.lastname: Hensler
authors.forename: J
authors.initials: J
authors.lastname: Rosenberg
mesh_terms: D059787:Acute Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006119:Groin; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D011788:Quality of Life; D013526:Surgical Mesh; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult