Comparative Study of Prolene Hernia System and Lichtenstein Method for Open Inguinal Hernia Repair PC04-PC07
Correspondence
Dr. Nitin Garg,
Associate Professor, Department of General Surgery, People’s College of Medical Sciences and Research Centre,
Bhanpur Bhopal, Madhy Pradesh, India.
E-mail : drnitin75@gmail.com
Background: Prolene Hernia System (PHS) is a bi-layered
polypropylene mesh with a connector that combines the anterior
and posterior inguinal hernia repair, but still not very popular
in this part of the country. Hence a prospective & randomized
comparative study was undertaken to compare PHS with the
already popular Lichtenstein Hernia Repair (LHR) and determine
the post-operative outcome.
Materials and Methods: Total 67 inguinal hernia repairs were
randomly assigned to either PHS or LHR method, and data was
collected regarding various outcome measures like duration of
surgery, post-operative pain, requirement of analgesia, return to
normal activity, and early and late complications.
Results: Mean duration of surgery was significantly higher for
PHS group than LHR group (65.4 min vs 51.26 min, p-value
< 0.0001). Significant difference was noted between the PHS
and LHR group in terms of moderate to severe post-operative
pain (15.15% vs 41.18%,p-value 0.018), time of requirement of
analgesia (3.7 vs 4.6 days, p-value 0.024), and time to return
to normal activity (2.7 vs 3.4 days, p-value 0.023), all in favour
of the former technique. No intra-operative complication was
noted in either of the groups. 5 patients had early complications
in PHS group and 6 in LHR group, but this was statistically not
significant. The average time of follow-up for the study was 7.8
month, ranging from 1 to 18 months. Chronic inguinal pain was
noted in 1 and 2 patients respectively in PHS and LHR group,
again statistically not significant. No recurrence was noted in
both the groups till the time of follow-up.
Conclusion: PHS is a safe and better alternative to the time
honored Lichtenstein hernia repair with the added advantage
of strengthening whole of myopectineal orifice, and virtually
eliminating any risk of recurrence.