Lichtenstein repair versus darning repair in direct inguinal hernia

ABSTRACT

To compare the merits of Lichtenstein repair with Darning repair in Army soldiers having direct inguinal hernia. Study Design and A comparative, interventional clinical study in 100 cases, carried out in Combined Military Hospital, Malir, Karachi and Pakistan Air Force Hospital Faisal Base, Karachi from March 2002 to March 2004. During the study period, serving soldiers reporting to the surgical outdoor department of both hospitals were selected according to the inclusion criteria and randomly assigned to either group A [Lichtenstein repair] or group B [Darning repair]. Written informed consent was obtained from all the patients before induction in the study groups. 50 patients each were assigned to both the groups. Thorough clinical examination and laboratory profile was done to assess pro operative fitness for general anesthesia. The parameters used to assess the results were duration of stay in hospital, patient comfort and fitness, complications and recurrence. After the respective procedure, as per the group of the patients, they were followed up on day 7, 1 month, 3 months, 6 months and 1 year. On each visit thorough history and clinical examination was done to assess the condition of the patient. Physical efficiency requirements for serving soldiers were also assessed and complications noted. Overall 58% patients presented with right inguinal hernia and 39% with a left, while 3% patients had bilateral hernia. The overall incidence of postoperative complications was 10.4%. Scrotal hematoma occurred in 3% in group A and 6% in group B. The wound infection occurred in 1% of patients in group A and 3% in group B. 10% of group A and 15% of group B had postoperative pain, which required oral NSAIDS for 4-7 days. 2% patients of group B and none of group A developed urinary retention post operatively. The incidence of complications and recurrence is lower in Lichtenstein repair as compared to Darning repair, therefore, we recommend Lichtenstein hernial repair for direct inguinal hernia