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Gold standard for inguinal hernia repair: Shouldice or Lichtenstein?

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Summary

In the knowledge that Lichtenstein inguinal hernia repair is becoming increasingly popular we evaluated this technique in a prospective randomized study. Would the Lichtenstein repair show significant advantages in order to justify it replacing the Shouldice technique, the standard for hernia repair of the last ten years? Between January 1996 and December 1997 the study was undertaken on 385 male patients suffering from 410 primary inguinal hernias. On 164 patients the Shouldice technique (SD) was used and on 221 patients the Lichtenstein repair (LS). 50 % of the operations were performed under local anesthesia, 50 % under spinal anesthesia. The 410 operations were done by 51 different surgeons, most of them in trainee programs. The postoperative local complication rate and duration of hospitalization were similar in both groups. Significant differences were noted concerning operation-time (LS: 80 min, SD: 88 min, p < 0,005) and return to work (LS: 25 days, SD: 41 days, p < 0,00005). The tension-free repair under local anesthesia described by Lichtenstein is an easy operation, with a low complication rate and short recovery period. The Lichtenstein technique is an ideal hernia repair with low costs, high patient comfort and suitability for day-surgery.

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References

  • Amid PK, Lichtenstein IL et al (1995) Biomaterials for ≪tension-free≫ hernioplasties and principles of their applications. Minerva Chir 50: 821–826

    PubMed  Google Scholar 

  • Amid PK, Shulman AG et al (1993) Critical scrutiny of the open ≪tension-free≫ hernioplasty. Am J Surg 165: 369–371

    PubMed  Google Scholar 

  • Barwell N (1981) Recurrence and early activity after groin hernia repair. Lancet 31: 985

    Google Scholar 

  • Bassini E (1890) Über die Behandlung des Leistenbruches. Langenbecks Arch Klin Chirurg 40: 429–476

    Google Scholar 

  • Bendavid R (1997) The Shouldice technique: a canon in hernia repair. Can J Surg 40: 199–205

    PubMed  Google Scholar 

  • Corlett MP, Pollock D et al (1995) Early results with Lichtenstein tension-free hernia repair (letter, comment). Br J Surg 82

  • Davies N, Thomas M et al (1994) Early results with the Lichtenstein tension-free hernia repair. Br J Surg 81: 1478–1479

    PubMed  Google Scholar 

  • Esbern F, Finn L (1996) The tension-free hernioplasty in a randomized trial. Am J Surg 172: 315–319

    PubMed  Google Scholar 

  • Glassow F (1973) The surgical repair of inguinal and femoral hernias. Can Med Assoc J 108: 308–313

    PubMed  Google Scholar 

  • Glassow F (1976) Short-stay surgery (Shouldice technique) for repair of inguinal hernias. Ann R Coll Surg Engl 58: 133–139

    PubMed  Google Scholar 

  • Guglielminetti D, Tugnoli G (1994) Hernioplasty compared: Shouldice-Trabucco-Lichtenstein. G Chir 15: 308–312

    PubMed  Google Scholar 

  • Hay JM, Boudet MJ et al (1995) Shouldice inguinal hernia repair in the male adult: the gold standard? A multicenter controlled trial in 1578 patients. Ann Surg 222: 719–727

    PubMed  Google Scholar 

  • Herzog U, Kocher T (1996) Leistenhernienchirurgie in der Schweiz 1994. Eine Umfrage an 142 Ausbildungskliniken in der Schweiz. Chirurg 67: 921–926

    PubMed  Google Scholar 

  • Hoffmann R, Frick T et al (1991) Bassini oder Shouldice? Helv chir Acta 58: 207–212

    PubMed  Google Scholar 

  • Kark AE, Kurzer M et al (1995) Tension-free mesh hernia repair: review of 1098 cases using local anaesthesia in a day unit. Ann R Coll Surg Engl 77: 299–304

    Google Scholar 

  • Kux M, Fuchsjager N et al (1994) Lichtenstein-Patch versus Shouldice Technik bei primären Leistenhernien mit hoher Rezidivgefährdung. Chirurg 65: 59–62

    PubMed  Google Scholar 

  • Lichtenstein IL (1970) Hernia repair without disability. St. Louis, CV Mosby Edn

    Google Scholar 

  • Lichtenstein IL, Shore JM (1974) Simplified repair of femoral and recurrent inguinal hernias by a ≪plug≫ technique. Am J Surg 128: 439

    PubMed  Google Scholar 

  • Lichtenstein IL, Shulman AG (1986) Ambulatory (outpatient) hernia surgery including a new concept: introducing tension-free repair. Int Surg 7: 1–4

    Google Scholar 

  • Lichtenstein IL, Shulman AG et al (1989) The tension-free hernioplasty. Am J Surg 157: 188–119

    PubMed  Google Scholar 

  • Paul A, Troidl H et al (1994) Randomized trial of modified Bassini versus Shouldice inguinal hernia repair. Br J Surg 81: 1531–1534

    PubMed  Google Scholar 

  • Schumpelick V (1984) Leistenbruch-Reparation nach Shouldice. Chirurg 55: 25–28

    PubMed  Google Scholar 

  • Shearburn EW, Myers RN (1969) Shouldice repair for inguinal hernia. Surgery 66: 450–459

    PubMed  Google Scholar 

  • Shulman AG, Amid PK et al (1992) The safety of mesh repair for primary inguinal hernias: results of 3,019 operations from five diverse surgical sources. Am Surg 58: 255–257

    PubMed  Google Scholar 

  • Wilson MS, Deans GT, et al (1995) Prospective trial comparing Lichtenstein with laparoscopic tension-free mesh repair of inguinal hernia. Br J Surg 82: 274–277

    PubMed  Google Scholar 

Download references

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Hetzer, F.H., Hotz, T., Steinke, W. et al. Gold standard for inguinal hernia repair: Shouldice or Lichtenstein?. Hernia 3, 117–120 (1999). https://doi.org/10.1007/BF01195308

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  • DOI: https://doi.org/10.1007/BF01195308

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