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Desarda’s technique versus Lichtenstein technique for the treatment of primary inguinal hernia: a systematic review and meta-analysis of randomized controlled trials

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An Invited commentary to this article was published on 01 February 2018

A Comment to this article was published on 10 November 2017

Abstract

Purpose

The Lichtenstein technique (LT) has been recognized as the standard treatment for inguinal hernia in adults owing to the high recurrence rates of tissue-based repairs. However, Desarda technique (DT) appeared as promising tissue-based repair that provided low incidence of recurrence without the need for implanting prosthetic or foreign materials in the inguinal canal. This meta-analysis of randomized controlled trials (RCTs) comparing DT and LT for primary inguinal hernia in adults aimed to determine which technique had better clinical outcome regarding recurrence and complication rates.

Methods

A systematic literature search for RCTs comparing between DT and LT was conducted using electronic databases and Google scholar service. Patients’ characteristics, technical details, recurrence and complication rates, and time to resume daily activities were extracted from the original studies and analyzed.

Results

Six RCTs comprising 2159 patients (89% males) were included. No significant difference in the incidence of recurrence between both techniques was detected (OR = 0.946; P = 0.91). The overall complication rate of LT was significantly higher than DT (OR = 1.86; P < 0.001). LT had significantly higher rates of seroma formation and surgical site infection (OR = 2.17; P = 0.007) and (OR = 2.17; P = 0.029), respectively. Postoperative pain, operation time, and time to resume normal activities were comparable in both groups.

Conclusion

Both DT and LT provided satisfactory treatment for primary inguinal hernia with low recurrence rates and acceptable rates of complications that were significantly less after DT. More well-designed RCTs with longer follow-up are required for further validation of the DT.

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Authors and Affiliations

  1. General Surgery Department, Faculty of Medicine, Mansoura University Hospitals, Elgomhuoria Street, Mansoura, Egypt

    S. H. Emile & H. Elfeki

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  1. S. H. Emile
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  2. H. Elfeki
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Contributions

Sameh Emile designed the study, shared in acquisition and analysis of data, and drafted the manuscript. Hossam Elfeki shared in acquisition and analysis of data, drafting and critical revision of the manuscript. Both authors approved the final version of the manuscript.

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Correspondence to S. H. Emile.

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Emile, S.H., Elfeki, H. Desarda’s technique versus Lichtenstein technique for the treatment of primary inguinal hernia: a systematic review and meta-analysis of randomized controlled trials. Hernia 22, 385–395 (2018). https://doi.org/10.1007/s10029-017-1666-z

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