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Mesh inguinal herniorrhaphy: a ten-year review
P G Janu1, K D Sellers, E C Mangiante
1Department of Surgery, University of Tennessee at Memphis 38163, USA.
The American Surgeon
|December 11, 1997
Summary
Mesh inguinal herniorrhaphy offers superior recurrence rates compared to non-mesh repairs. This study found open mesh repair significantly reduces recurrence without increasing infection risk or hospital stay.
Area of Science:
- General Surgery
- Surgical Innovation
Background:
- Inguinal herniorrhaphy is a common surgical procedure with 10-20% recurrence rates.
- Mesh repair, favored by specialized centers, shows a low 0.2% recurrence rate.
- Concerns regarding mesh repair include cost, technical difficulty, and infection risk.
Purpose of the Study:
- To compare the outcomes of mesh versus non-mesh inguinal herniorrhaphy at a large teaching institution.
Main Methods:
- A retrospective study of 892 patients undergoing primary inguinal hernia repair from 1985-1994.
- Patients were stratified by repair type: Lichtenstein (Mesh), open anterior (Bassini, Marcy, McVay, Shouldice), laparoscopic (Lap), and preperitoneal (Post).
- Outcomes analyzed included operative time, hospital stay, wound infections, and recurrence rates.
Main Results:
- Mesh repair operative time (111 min) was longer than Bassini/McVay (91/98 min) but shorter than laparoscopic (192 min).
- Hospital stay and wound infection rates were not significantly different between mesh and non-mesh groups.
- Mesh repair demonstrated a significantly lower recurrence rate (0.3%) compared to open anterior repair (3.5%).
Conclusions:
- Open mesh inguinal herniorrhaphy provides superior recurrence rates compared to traditional non-mesh techniques.
- Mesh repair does not increase the risk of infection, length of stay, or technical difficulty.
- This study supports the efficacy of mesh repair for primary inguinal hernias.