title: Randomized clinical trial of mesh fixation with glue or sutures for Lichtenstein hernia repair.
abstract: BACKGROUND
  Pain is the most likely reason for delay in resuming normal activities after groin hernia repair. The primary aim of this study was to determine whether the use of glue to fix the mesh instead of sutures reduced acute postoperative pain after inguinal hernia repair. Secondary objectives were to compare postoperative complications, chronic pain and early recurrence rates during 1-year follow-up.
  
  
  METHODS
  Some 370 patients who underwent Lichtenstein hernia repair were randomized to receive either glue (Histoacryl®) or non-absorbable polypropylene sutures for fixation of lightweight polypropylene mesh. Postoperative complications, pain and recurrence were evaluated by an independent blinded observer.
  
  
  RESULTS
  Postoperative pain at 8 h, 24 h, 7 days and 30 days was less when glue was used instead of sutures for all measures (P < 0·001). The operation was significantly quicker using glue (mean(s.d.) 35·3(8·7) min versus 39·9(11·1) min for sutures; P < 0·001). There were no significant differences between the groups in terms of postoperative complications, chronic pain and early recurrence at 1-year follow-up.
  
  
  CONCLUSIONS
  Atraumatic mesh fixation with glue was quicker and resulted in less acute postoperative pain than sutures for Lichtenstein hernia repair. Registration number: NCT02632097 (http://www.clinicaltrials.gov).
authors.affiliation: Department of General and Digestive Surgery, Hospital Platón, Barcelona, Spain.
authors.forename: C
authors.identifier: http://orcid.org/0000-0002-6539-0439
authors.initials: C
authors.lastname: Hoyuela
authors.affiliation: Department of General and Digestive Surgery, Hospital Platón, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Juvany
authors.affiliation: Department of General and Digestive Surgery, Hospital Platón, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Carvajal
authors.affiliation: Department of Surgery, Hospital de la Cerdanya, Puigcerdà, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Veres
authors.affiliation: Department of General and Digestive Surgery, Hospital Platón, Barcelona, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Troyano
authors.affiliation: Department of General and Digestive Surgery, Hospital Platón, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Trias
authors.affiliation: Department of General and Digestive Surgery, Hospital Platón, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Martrat
authors.affiliation: Department of General and Digestive Surgery, Hospital Platón, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ardid
authors.affiliation: Department of General and Digestive Surgery, Hospital Platón, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Obiols
authors.affiliation: Department of General Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: López-Cano
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D013526:Surgical Mesh; D013537:Sutures; D014014:Tissue Adhesives / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014014:Tissue Adhesives