Evaluation of 335 inguinal hernia repair by Lichtenstein technique: a retrospective study

Year 2019, , 1317 - 1324, 15.04.2019

Tayfun Bilgiç

https://doi.org/10.30569/adiyamansaglik.474539

Abstract

Aim: The aim of this retrospective study was to evaluate
of 335 inguinal hernia
repair by Lichtenstein technique in elective inguinal hernia
management.

Materyal and Methods: Three hundred fifty-five
patients who administered to the General Surgery Clinic between Jan 2004 and
Jan 2006 underwent inguinal hernia repair with the “Lichtenstein-tension-free”
surgery technique were retrospectively evaluated in respect to demographics,
recurrence and postoperative complications. Follow-up data were obtained from hospital charts,
recurrence and late complications were evaluated in telephone interview.

Results: 313 patients out of 355 were
(88.2%) men and 42 (11.8%) were women. The mean age was 54 years (ranged 21-76
years). The hernia was on the right side in 241 patients (67.9%) and on the
left side in 91patients (25.6%). 194 of 355 (54.7%) patients have indirect hernia.
The postoperative mean hospital stay was 1.1 days (range 1-3 days). The most
common postoperative early complication was urinary retantion.  The late period complications
including chronic pain in 3 patients (0.8 %), testicular atrophy in 2 patients
(0.5 %), and recurrence in 4 patients (1.1%).

Conclusion: this study shown that
Lichtenstein technique for inguinal hernia repair  is a safe and feasible
surgery method in respect to 1.1% recurrence and 22.6% overall post-operative
complication rate. 

Keywords

Inguinal hernia, Lichtenstein-tension-free technique, complications

CLASSIFICATION OF THE 355 OPERATED INGUINAL HERNIA AND THE POSTOPERATIVE EVALUATION OF THE LICHTENSTEIN METHOD

Abstract

Amaç: Bu çalışmanın
amacı kliniğimizde inguinal herni nedeniyle opere edilen hastaların analizini
yapmak ve hastanın hastanede kalış süresini, post operatif rahatsızlığını,
iyileşme süresini ve “Lichtenstein-tension-free” gerilimsiz greft ile herni
tamiri operasyon yönteminin erken ve geç komplikasyonlarını tespit etmektir.

Yöntem:
Genel Cerrahi Kliniği’ne son 24 ay içerisinde başvuran ve inguinal herni tanısı
ile “Lichtenstein-tension-free” ameliyat yöntemi ile
opere edilen 355 hasta çalışmaya dahil edilmiştir.

Bulgular: Çalışmaya alınan
hastalardaki ameliyat eksplorasyon bulgusu değerlendirildiğinde 194 (%54.7)
hastada indirekt, 102 (%28.8) hastada direkt, 24 (%6.7) hastada pantolon ve 35
(%9.8) hastada femoral herni olduğu saptandı. Postoperatif takip edilen
hastalarda görülen erken komplikasyonlardan en sık spinal anesteziye bağlı
gelişen idrar retansiyonu (25
hasta, %7) gözlendi.
Çalışmaya dahil edilen hastaların geç dönem komplikasyonları sorgulandığında;
3 hastada nöralji (%0.8), 2 hastada (%0.5) testiküler atrofi,
1 hastada (%0.2) mesh reaksiyonu ve
4 hastada nüks (%1.1) saptandı.

Sonuç: Lichtenstein yöntemi modern ameliyat yönteminin gerektirdiği tüm istekleri
karşılar ve neredeyse sıfıra yakın nüks oranı bulunmaktadır

Keywords

İnguinal herni, Lichtenstein-tension-free tekniği, komplikasyon

References

• 1. Kingsnorth A, LeBlanc K. Hernias: inguinal and incisional. Lancet 2003;362(9395):1561-71.
• 2. Palermo M, Acquafresca PA, Bruno M, Tarsitano F. Hernioplasty with and without mesh: analysis of the immediate complications in a randomized controlled clinical trial. Arq Bras Cir Dig 2015;28(3):157-60.
• 3. Amid PK, Lichtenstein IL. Current assessment of Lichtenstein tension-free hernia repair. Chirurg 1997; 68(10):959-64.
• 4. Pielaciński K, Wróblewski T, Wójtowicz J. Results of inguinal hernia repair by Lichtenstein method in material of Surgical Ward of the District Hospital in Żyrardow. Videosurgery Miniinv 2007;2(6):66–75.
• 5. Liu Y, Shen Y, Chen J. Effects of non-woven mesh in preperitoneal tension-free inguinal hernia repair: a retrospective cohort study. Minerva Chir 2017;72(4):311-6.
• 6. Reinpold W, Chen D. Evidence-based Lichtenstein technique. Chirurg 2017;88(4):296-302.
• 7. Lichtenstein IL, Shulman AG, Amid PK, Montlor MM. The tension-free hernioplasty. Am J Surg 1989; 157(2):188-93.
• 8. Rahul B.G, Ravindranath G.G. Incidence of inguinal hernia and its type in a study in a semiurban area in Andhra Pradesh, India. Int Surg J 2016;3(4):1946-9.
• 9. Ruthlege RH, Cooper’s Ligament repair, a 25 year expriens with a single technique for all groin hernias in adults, Surgery 1988;103: 1-10.
• 10. Arat IR, Fıtıklar, in: Değerli Ü (Ed) Genel Cerrahi. İst, Ed, İstanbul Tıp Fak, 461-88.
• 11. S Aldoescu, T Patrascu, I Brezean. Predictors for length of hospital stay after inguinal hernia surgery. J Med Life 2015; 8(3): 350–5.
• 12. Simons MP, Aufenacker T, Bay-Nielsen M, and et all. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2009; 13(4): 343–403.
• 13. Prakash D, Heskin L, Doherty S, Galvin R. Local anaesthesia versus spinal anaesthesia in inguinal hernia repair: A systematic review and meta-analysis. Surgeon 2017;15(1):47-57.
• 14. Narkhede R, Shah NM, Dalal PR, Mangukia C, Dholaria S. Postoperative Mesh Infection— Still a Concern in Laparoscopic Era. Indian J Surg 2015;77(4):322-6.
• 15. Paton BL, Novitsky YW, Zerey M, Sing RF, Kercher KW, Heniford BT. Management of infections of polytetrafluoroethylene-based mesh. Surg Infect (Larchmt) 2007;8(3):337–41.
• 16. Serbetci K, Kulacoglu H, Devay AO, Hasirci N. Effects of resterilization on mechanical properties of polypropylene meshes. Am J Surg 2007;194(3):375-9.
• 17. Zhiyong Dong, Stacy Ann Kujawa, Cunchuan Wang, Hong Zhao. Does the use of hernia mesh in surgical inguinal hernia repairs cause male infertility? A systematic review and descriptive analysis. Reprod Health. 2018; 15: 69.
• 18. Martin F Bjurstrom, Andrea L Nicol, Parviz K Amid, David C Chen. Pain control following inguinal herniorrhaphy: current perspectives. J Pain Res 2014;7: 277-90.
• 19. Macrae WA, Davies HTO. Chronic postsurgical pain. In: Crombie IK, Croft PR, Linton SJ, LeResche L, Von Korff M, editors. Epidemiology of Pain. Seattle: IASP Press; 1999. pp. 125–142.
• 20. Nordin P, van der Linden W. Volume of procedures and risk of recurrence after repair of groin hernia: national register study. BMJ 2008;336(7650):934–7.
• 21. The HerniaSurge Group Hernia. International guidelines for groin hernia management 2018; 22(1): 1–165.
• 22. Eklund AS, Montgomery AK, Rasmussen IC, Sandbue RP, Bergkvist LA, Rudberg CR. Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal hernia repair: a randomized, multicenter trial with 5-year follow-up. Ann Surg. 2009;249(1):33-8.