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Shouldice technique versus other open techniques for inguinal hernia repair.
Bruno Amato1, Lorenzo Moja, Salvatore Panico
1Dipartimento di Chirurgia Generale (Edif. 6), Universita degli Studi di Napoli, Via S. Pansini, 5, Napoli, Italy, 80131.
The Cochrane Database of Systematic Reviews
|October 13, 2009
Summary
The Shouldice technique for inguinal hernia repair has a higher recurrence rate than mesh but is the best non-mesh option. Mesh repair offers lower recurrence, with no significant differences in pain or complications.
Area of Science:
- General Surgery
- Surgical Techniques
- Hernia Repair
Background:
- Inguinal hernia repair is a common general surgery procedure.
- Various techniques exist, with Shouldice and mesh repairs being prominent.
- Outcome measures like recurrence rates and complications differ across techniques.
Purpose of the Study:
- To compare the efficacy and safety of the Shouldice technique against other non-laparoscopic methods for hernia repair.
Main Methods:
- A systematic review of randomized controlled trials (RCTs) was conducted.
- Searches included MEDLINE, EMBASE, and CENTRAL up to April 2008.
- Sixteen RCTs involving 2566 hernias were analyzed.
Main Results:
- Shouldice repair had a higher recurrence rate than mesh repair (OR 3.80) but lower than non-mesh techniques (OR 0.62).
- No significant differences were observed in chronic pain, complications, or post-operative stay.
- Female patients constituted approximately 3% of the study population.
Conclusions:
- Shouldice herniorrhaphy is the superior non-mesh technique for reducing recurrence.
- Mesh techniques demonstrate a lower recurrence rate.
- Study quality was generally low, and patient characteristics may influence recurrence rates in the broader population.