COMPARISON OF POSTOPERATIVE PAIN IN DESARDA VS LICHTENSTEIN MESH REPAIR IN THE TREATMENT OF INGUINAL HERNIAS

Kaleem Ullah; Shahidullah Ahmad; Sheikh Muhammad Ibqar Azeem; Waleed Mabood; Sahibzda Salma Rahman; Nasir Bakhtiar

doi:10.46903/gjms/21.04.1331

COMPARISON OF POSTOPERATIVE PAIN IN DESARDA VS LICHTENSTEIN MESH REPAIR IN THE TREATMENT OF INGUINAL HERNIAS

Kaleem Ullah, Shahidullah Ahmad, Sheikh Muhammad Ibqar Azeem, Waleed Mabood, Sahibzda Salma Rahman, Nasir Bakhtiar

Abstract

Background: Inguinal hernia is a protrusion of a viscus or part of a viscus in the inguinal canal either through the internal ring or a weakness in its posterior wall. Inguinal hernia repair is one of the most frequently performed surgeries in the world. The objective of this study was to compare the mean postoperative pain in Desarda vs Lichtenstein Mesh repair in the treatment of inguinal hernia.

Materials & Methods: This randomized controlled trial was conducted at Surgery Department Mercy Teaching Hospital, Peshawar Medical College and District Headquarter Hospital Daggar, Buner from January 2022 to December 2022. Two hundred thirty-eight patients were equally & randomly allocated by toss method into two groups i.e., Experimental group (Desarda’s repair group) & Control group (Lichtenstein Mesh repair group).
The data for the sample were elaborated by counts & percentages and for the population as confidence interval with 95% confidence level. The mean pain between 2 groups was compared using independent sample t-test.

Results: Mean pain at 24 hours was same in both groups i.e., 2.62 in Desarda group as compared to 2.71 in Lichtenstein Mesh repair group & at 3 days was also same in both groups i.e., 2.26 in Desarda group as compared to 2.21 in Lichtenstein Mesh repair group. Mean pain score at 7 days was statistically significant i.e., p-value<0.05. Mean pain score was 2.17 in Desarda group as compared to 2.18 in Lichtenstein Mesh repair group.

Conclusion: Our study concludes that early postoperative mean pain at one week of follow up is less in Desarda repair as compared to Lichtenstein repair in the treatment of inguinal hernia & the results are statistically significant.

Keywords

Post-operative Pain; Direct Inguinal Hernia; Indirect Inguinal Hernia; Herniorrhaphy; Hernioplasty.

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References

Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, et al. European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 2009 Aug; 13:343-403. https://doi.org/10.1007/s10029-009-0529-7

Primatesta P, Goldacre MJ. Inguinal hernia repair: incidence of elective and emergency surgery, readmission and mortality. Int J Epidemiol 1996;25(4):835-9. https://doi.org/10.1093/ije/25.4.835

Awad SS, Fagan SP. Current approaches to inguinal hernia repair. Am J Surg 2004 Dec 1;188(6):9-16. https://doi.org/10.1016/j.amjsurg.2004.09.007

Bay-Nielsen M, Kehlet H, Strand L, Malmstrøm J, Andersen FH, Wara P, et al. Quality assessment of 26 304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 2001;358(9288):1124-8. https://doi.org/10.1016/S0140-6736(01)06251-1

Testini M, Lissidini G, Poli E, Gurrado A, Lardo D, Piccinni G. A single-surgeon randomized trial comparing sutures, N-butyl-2-cyanoacrylate and human fibrin glue for mesh fixation during primary inguinal hernia repair. Can J Surg 2010;53(3):155.

Gedam BS, Bansod PY, Kale VB, Shah Y, Akhtar M. A comparative study of Desarda's technique with Lichtenstein mesh repair in treatment of inguinal hernia: A prospective cohort study. Int J Surg 2017; 39:150-5. https://doi.org/10.1016/j.ijsu.2017.01.083

Jain SK, Hameed T, Jain D, Singh M, Nizam A. The Role of Antibiotic Prophylaxis in Lichtenstein Repair of Primary Inguinal Hernia: A Prospective Double-Blind Randomized Placebo-Controlled Trial. Niger J Surg 2021;27(1):5-8. https://doi.org/10.4103/njs.NJS_52_19

Ali A, Bukhari SU, Awan SA, Ahmed U, Ahmed A, Babar MW. Comparison between Desarda's Inguinal Hernia Repair and Lichtenstein Hernioplasty in terms of Complications, Operative time and Cost-effectiveness. PAFMJ 2022;72(4):1339-42. https://doi.org/10.51253/pafmj.v72i4.8016

Jianxin Z, Dong JW, Zhiyong Z. Desarda inguinal hernia repair and synthetic patch (open VS TEP) hernia repair comparative study. J Chinese Her Abdominal Surg 2013;7(1): 559-553.

D'amore L, Gossetti F, Vermeil V, Negro P. Long-term discomfort after plug and patch hernioplasty. Hernia 2008;12:445-6. https://doi.org/10.1007/s10029-008-0349-1

Stephen JN, Bruce T. Abdominal Wall hernia and hernia and umbilicus. Bailey and Love's; Short practice of surgery; 26th ed, 2013, [Internet] available at: https://www.taylorfrancis.com/chapters/mono/10.1201/9781315111087-60/abdominal

Ahmed N, Kumar V. A study on the short-term outcomes and recurrence rate between Lichtenstein's and Desarda technique in management of inguinal hernia. Int J Surg 2021; 5(1):163-165. https://doi.org/10.33545/surgery.2021.v5.i1c.609

Ramu AH, Kenchetty P, Chidananda AK. Desarda versus Lichtenstein repair in treatment of inguinal hernia: our experience in KVG Medical College and Hospital. Int Surg J 2021;9(1):111-117. https://doi.org/10.18203/2349-2902.isj20215141

Jain SK, Bhatia S, Hameed T. A randomized controlled trial of Lichtenstein repair with Desarda repair in the management of inguinal hernias. Ann Med Surg (Lond) 2021;67(1):102486. https://doi.org/10.1016/j.amsu.2021.102486

Ansari FM, Hameed T, Jain SK, Dua A, Nizam A. Comparison of outcome of Desarda versus Bassini repair in management of complicated inguinal hernia. Int Surg 2019;6(11):3889-96. https://doi.org/10.18203/2349-2902.isj20194574

Mitura K, Rzewuska A, Rzewuska MS. Desarda technique as a valuable alternative for inguinal hernia patients refusing mesh implantation: long-term results fifteen years after a pure tissue repair in 198 patients. Mini Invasive Surg 2021;5(1):22-6. https://doi.org/10.20517/2574-1225.2021.19

Szopinski J, Dabrowiecki S, Pierscinski S, Jackowski M, Jaworski M, Szuflet Z. Desarda versus Lichtenstein technique for primary inguinal hernia treatment: 3-year results of a randomized clinical trial. World J Surg 2012;36:984-92. https://doi.org/10.1007/s00268-012-1508-1

Youssef T, El-Alfy K, Farid M. Randomized clinical trial of Desarda versus Lichtenstein repair for treatment of primary inguinal hernia. Int J Surg 2015;20:28-34. https://doi.org/10.1016/j.ijsu.2015.05.055

Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Prev Med 2007;45(4):247-51. https://doi.org/10.1016/j.ypmed.2007.08.012

Zinner MJ, Schwartz SI, Ellis H. Maingot's abdominal operations. J Am Coll Surg 1997;3(185):307.

Rutkow IM. Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin N Am 2003;83(5):1045-51. https://doi.org/10.1016/S0039-6109(03)00132-4

Fitzgibbons Jr RJ, Forse RA. Groin hernias in adults. N Engl J Med 2015;372(8):756-63. https://doi.org/10.1056/NEJMcp1404068

A.S. Poobalan, J. Bruce, W.C. Smith, P.M. King, Z.H. Krakowski, W.A. Chambers, A review of chronic pain after inguinal herniorrhaphy. Clin J Pain 2003;19(1):48-54. https://doi.org/10.1097/00002508-200301000-00006

Natarajan B, Burjonrappa SC, Cemaj S, Fitzgibbons RJ Jr. Basic features of groin hernia and its repair. In: Yeo CJ, editor. Shackelford’s Surgery of the Alimentary Tract. Toronto, ON, Canada: Elsevier; 2013. p. 556–82. https://doi.org/10.1016/B978-1-4377-2206-2.00046-4

DOI: https://doi.org/10.46903/gjms/21.04.1331