title: Randomized Clinical Trial Comparing Cyanoacrylate Glue Versus Suture Fixation in Lichtenstein Hernia Repair: 7-Year Outcome Analysis.
abstract: Lichtenstein hernioplasty has relatively low recurrence rate, but chronic inguinal pain may cause harm to the patient. The aim of our study was to compare long-term results of cyanoacrylate glue versus absorbable sutures for mesh fixation in Lichtenstein hernioplasty.
  
  
  
  Lichtenstein hernioplasty (n = 302) was performed under local anesthesia in three hospitals. The patients were randomized to receive either 1 ml of butyl-2-cyanoacrylate tissue glue (Glubran®; 151 hernias) or absorbable polyglycolic acid sutures (Dexon®; 151 hernias) for mesh fixation (Optilene®mesh). Short-term results were published previously. Chronic groin pain, foreign body sensation, use of analgesics, recurrence and re-operations were analyzed 7 years after surgery.
  
  
  
  We reached 236 patients (78%) to present study. In the glue group (n = 115), there were five (4.3%) and in the suture group (n = 121) three (2.5%) recurrent hernias (p = 0.491). The prevalence of chronic pain (NRS ≥ 3) in the patients without re-operations was similar in two groups: 15/118 (13%) and 13/111 (12%), respectively (p = 0.843). There were no significant differences in the foreign body sensation (8/14, p = 0.267) or in the need of analgesics (2/2, p = 1.00) between the two study groups.
  
  
  
  Both cyanoacrylate glue and mesh fixation with absorbable sutures were equal in terms of chronic pain and rate of recurrences in Lichtenstein hernioplasty after 7-year follow-up.
  
  
  
  NCT00659542.
authors.affiliation: Department of Surgery, Kuopio University Hospital, Kuopio, Finland. markku.matikainen@pkssk.fi.|School of Medicine, University of Eastern Finland, Kuopio, Finland. markku.matikainen@pkssk.fi.|Department of Surgery, North Karelia Central Hospital, Joensuu, Finland. markku.matikainen@pkssk.fi.
authors.forename: M
authors.initials: M
authors.lastname: Matikainen
authors.affiliation: Department of Surgery, Paijat-Hame Central Hospital, Lahti, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Kössi
authors.affiliation: Department of Surgery, North Karelia Central Hospital, Joensuu, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Silvasti
authors.affiliation: Department of Surgery, North Karelia Central Hospital, Joensuu, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Hulmi
authors.affiliation: Department of Surgery, Kuopio University Hospital, Kuopio, Finland.|Department of Surgery, Mikkeli Central Hospital, Mikkeli, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Paajanen
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000209:etiology / Q000517:prevention & control; D003487:Cyanoacrylates; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D011100:Polyglycolic Acid; D011446:Prospective Studies; D012008:Recurrence; D013526:Surgical Mesh; D013536:Suture Techniques; D013537:Sutures; D014014:Tissue Adhesives; D016896:Treatment Outcome
chemical_list: D003487:Cyanoacrylates; D014014:Tissue Adhesives; C421460:glubran; D011100:Polyglycolic Acid