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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, Napoli, Italy.bramato@unina.it.
The Cochrane Database of Systematic Reviews
|April 20, 2012
Summary
The Shouldice technique for inguinal hernia repair shows a higher recurrence rate than mesh but is superior to other non-mesh methods. Mesh repair offers the lowest recurrence, with no significant differences in pain or complications across techniques.
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 and complications differ significantly between methods.
Purpose of the Study:
- To compare the efficacy and safety of the Shouldice technique against other non-laparoscopic hernia repair methods.
- Evaluate recurrence rates, complications, and post-operative stay.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) from MEDLINE, EMBASE, and CENTRAL.
- Searches updated through September 2011.
- Inclusion criteria: RCTs on primary inguinal hernia repair in adults.
Main Results:
- Sixteen trials involving 2566 hernias were analyzed.
- Shouldice technique had higher recurrence than mesh (OR 3.80) but lower than non-mesh (OR 0.62).
- No significant differences observed in chronic pain, complications, or post-operative stay.
Conclusions:
- Shouldice herniorrhaphy is the best non-mesh option for recurrence but is more time-consuming.
- Mesh repair is associated with lower recurrence rates.
- Study quality was low, and patient characteristics may influence results; mesh offers superior recurrence outcomes.