Comparison of open preperitoneal mesh vs. Lichtenstein Technique for repair of recurrent inguinal hernia

Repair of recurrent inguinal hernia is associated with high re-recurrece possibility and more surgical complications. This study compares open preperitoneal mesh vs. Lichtenstein technique for repair of recurrent inguinal hernia. In a prospective clinical trial 60 patients with recurrent inguinal hernias were evaluated. 30 patients were operated on using Lichtenstein technique and 30 patients were operated on using open preperitoneal mesh repair technique by the method of Wantz. Patients with BMI>35, under treatment with corticosteroid, diabetes mellitus, coagulation disorders, female gender and previous abdominal surgery unless hernia repair were excluded. The patients evaluated 2 and 6 weeks and 3-12 months after operation. Mean follow-up period was 8 months. Data were analyzed with SPSS15th, and presented with Fisher’s exact test, chi-square and T tests.p value equal to0.05was considered meaningful. There were no major complications. There was 20% recurrence in Lichtenstein group vs. 0% in open preperitoneal group (P: 0.01). Nerve injury (sensory impairment or neuralgia confirmed by physical examination.) was seen in 20% of Lichtenstein group and without any of nerve injury in open preperitoneal group (P: 0.01). Ischaemic orchitis was seen in 23.3% of Lichtenstein group and without any of ischaemic orchitis in open preperitoneal group (P: 0.005). Other complications such as infection, hematoma, urinary retention, testicular atrophy showed no significant level of difference. open preperitoneal technique for repair of recurrent inguinal hernia precedes in patients with previously anterior approach operation and is associated with less recurrence and nerve injuries