Comparing non-mesh and sutured inguinal hernia repairs in groin surgery: a randomized clinical trial

ABSTRACT

Mesh technique is the standard for inguinal hernia repair because of less recurrence, but it is inferior or equal to sutured technique in case of other post-operative complications such as chronic pain. This clinical trial set out to compare these two techniques. A total number of 322 cases of unilateral inguinal hernia in participants older than 18 years old were divided into 158 cases for mesh [Lichtenstein] and 164 for nonmesh [Bassini-McVay] hernia repair techniques. In order to compare the complications in the two groups, they were followed up from one to five years. During the study period, 12 and 7 participants were excluded from the mesh and non-mesh suture groups, leaving 146 and 157 participants in each group, respectively. The mean ages were 50.9 and 46.6 years old in mesh and sutured groups, respectively and mean follow up time was 2.9 years. Compared to mesh group, all complications were equal or less in non-mesh group, except for recurrence which had a statistically significant difference. Chronic post-operative pain, foreign body sensation, returning time to daily activities and costs were significantly less in non-meshed group [P = .0083]. Non-mesh suture technique still has its place in hernia repair. Mesh can be preserved for special conditions such as weak fascia wall, contralateral unsuccessful surgery, and recurrence, if suture technique is expensive or not easily available