Comparison of the ONSTEP and Lichtenstein techniques for inguinal hernia repair-early results of a prospective study

Aim: The study aims to evaluate the impact of the ONSTEP technique on the intensity of the systemic inflammatory response syndrome (SIRS) and the outcomes of inguinal hernia treatment compared to the Lichtenstein technique. .

Materials and Methods: In 41 men randomized into 2 study groups, unilateral inguinal hernia repair was performed using the ONSTEP technique in group O and the Lichtenstein technique in group L. A total of 34 men met the full inclusion criteria, with each group consisting of 17 patients. Data were collected prospectively during hospitalization, as well as on day 7 and at 3 and 12 months postoperatively. Pain intensity was assessed using the Numerical Rating Scale (NRS). The severity of the systemic inflammatory response syndrome (SIRS) was evaluated based on changes in the following parameters: leukocyte and platelet counts, levels of interleukin-6, C-reactive protein (CRP), and fibrinogen at 6, 24, 46, and 168 hours postoperatively.

Results: No statistically significant differences were observed between the study groups in the incidence of CPP, the need for analgesics, recurrence rates, SIRS severity, or operative time. However, the ONSTEP technique was associated with significantly lower acute postoperative pain intensity and a quicker return to daily activities compared to the Lichtenstein technique.

Conclusions: Compared with the Lichtenstein technique, the ONSTEP technique shows similar intensity of SIRS and mostly comparable results in treatment, however the intensity of intense acute postoperative pain is lower and the return to preoperative activity proceeds faster.