[Inguinal hernioplasty by a modified Shouldice technic. Our experience with 350 treated cases]

Area of Science:

• Surgery
• Gastroenterology
• Clinical Research

Background:

• Inguinal hernias are a common surgical condition.
• Various surgical techniques exist for inguinal hernia repair, each with varying recurrence rates.
• The Shouldice procedure is a specific method for hernia repair with a focus on tissue repair.

Purpose of the Study:

• To evaluate the long-term efficacy and safety of the Shouldice procedure for inguinal hernia repair.
• To assess recurrence rates and postoperative complications associated with the Shouldice technique.
• To compare the reliability of the Shouldice procedure with other historical hernia repair methods.

Main Methods:

• A statistical analysis of 340 patients undergoing inguinal hernia repair using the Shouldice procedure between 1986 and 1991.
• A mean follow-up of 30 months (range 1-6 years) for 82% of patients, including physical examination and questionnaires.
• Literature review comparing the Shouldice technique with previous methods (Bassini, McNealy, Postemskj, Mugnai-Ferrari).

Main Results:

• The majority of patients (60%) were aged 45-65 years.
• No hernia recurrences were observed in 128 high-risk patients (45% of controls).
• 93% of patients had an uncomplicated postoperative course; 7% experienced loco-regional complications, with local infections/edema in 22 patients and anesthetic-related issues in 5% (17 cases). No deaths or pulmonary embolisms occurred.

Conclusions:

• The Shouldice procedure demonstrates high reliability and a low recurrence rate for inguinal hernia repair.
• The technique is effective even in high-risk patient populations.
• Compared to historical methods, the Shouldice procedure offers superior reliability in preventing hernia recurrence.