Inguinal hernia: Lichtenstein VS Shouldice technique repair: A randomized controlled trial.

Area of Science:

• General Surgery
• Surgical Techniques

Background:

• Inguinal hernia repair is a common surgical procedure, with lifetime risks of 27% for men and 3% for women.
• The Lichtenstein technique (mesh-based) is the standard for elective adult inguinal hernia repair per European Hernia Society guidelines.
• The Shouldice technique (tissue-based) is considered a leading conventional open repair method.

Purpose of the Study:

• To compare the efficacy and outcomes of the Lichtenstein technique versus the Shouldice technique for inguinal hernia repair.
• To evaluate recurrence rates, complications, and patient satisfaction between the two surgical methods.

Main Methods:

• A randomized study involving 452 patients, with 391 analyzed after exclusions (183 Shouldice, 218 Lichtenstein).
• Patients were followed for up to 3 years post-operation.
• Data collected included hernia recurrence, wound infection, seroma, hematoma, hydrocele, bladder damage, chronic pain, and patient satisfaction.

Main Results:

• After 3 years, hernia recurrence was significantly lower in the Lichtenstein group (3%) compared to the Shouldice group (7.1%) (p=0.006).
• No significant differences were observed between the groups regarding wound infection, seroma, hematoma, hydrocele, bladder damage, chronic pain, or patient satisfaction.

Conclusions:

• The Lichtenstein technique appears to be superior to the Shouldice technique for elective inguinal hernia repair.
• The mesh-based Lichtenstein repair offers a lower risk of recurrence without compromising other safety or satisfaction outcomes.