Abstract
Introduction
The Lichtenstein hernioplasty for the repair of primary inguinal hernia in male patients is well established and constitutes the current gold standard. However a gold standard technique for the repair of recurrent inguinal hernia has not been established. The aim of this study was to analyze the outcomes of Lichtenstein hernioplasty for the repair of primary inguinal hernia and recurrent inguinal hernia, applying for that purpose the Qualitative and Quantitative Measurement Instrument (QQMI).
Methods
We studied 75 recurrent inguinal hernia patients and 287 primary inguinal hernia patients with a follow-up period ranging from 60 to 107 months.
Results
The final QQMI score demonstrated that most patients in both groups reached scores between 8 and 11 points, with a significant difference in the maximum score (11 points) favoring primary hernia patients.
Conclusions
All evaluated parameters showed better outcomes in primary hernia patients. Applying the QQMI, we have demonstrated that the outcomes of Lichtenstein hernioplasty are not similar between primary and recurrent inguinal hernia; there is a tendency toward better outcomes for primary inguinal hernia patients, although the Lichtenstein hernioplasty stands as a safe option for repair of recurrent inguinal hernias.
Similar content being viewed by others
References
Lichtenstein IL, Shulman AG, Amid PK, et al. The tension-free hernioplasty. Am J Surg 1989;157:188–193
Wantz GE. Experience with the tension-free hernioplasty for primary inguinal hernias in men. J Am Coll Surg 1996;183:351–356
Hernandez-Granados P, Ontañon M, Lasala M, et al. Tension-free hernioplasty in primary inguinal hernia: a series of 2054 cases. Hernia 2000;4:141–143
Voigt WJ, Gilbert AI. Tension-free inguinal hernia repair. Probl Gen Surg 2002;19:27–35
Amid PK. The Lichtenstein repair in 2002: an overview of causes of recurrence after Lichtenstein tension-free hernioplasty. Hernia 2003;7:13–16
Forte A, D’Urso A, Palumbo P, et al. Inguinal hernioplasty: the gold standard of hernia repair: Hernia 2003;7:35–38
Amid PK. Lichtenstein tension-free hernioplasty: its inception, evolution, and principles. Hernia 2004;8:1–7
Barrat C, Surlin V, Bordea A, et al. Management of recurrent inguinal hernias: a prospective study of 163 cases. Hernia 2003;7:125–129
Richards SK, Vipond MN, Earnshaw JJ. Review of the management of recurrent inguinal hernia. Hernia 2004;8:144–148
Verstraete L, Swannet H. Long-term follow-up after Lichtenstein hernioplasty in a general surgical unit. Hernia 2003;7:185–190
Beltrán MA, Burgos C, Almonacid J, et al. Long-term follow-up of tension-free Lichtenstein hernioplasty: application of a qualitative-and-quantitative measurement instrument. Hernia 2005;9:368–374
Gilbert AI. An anatomic and functional classification for the diagnosis and treatment of inguinal hernia. Am J Surg 1989;157:331–334
Rutkow IM, Robbins AW. “Tension-free” inguinal herniorrhaphy: a preliminary report on the “mesh-plug” technique. Surgery 1993;114:3–7
Kehlet H, Bay-Nielsen M, Kingsnorth A. Chronic postherniorrhaphy pain—a call for uniform assessment. Hernia 2002;6:178–181
Bay-Nielsen M, Kehlet H, Strand L, et al. Quality assessment of 26,304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 2001;358:1124–1128
Nordin P, Bartelmess P, Jansson C, et al. Randomized trial of Lichtenstein versus Shouldice hernia repair in general surgical practice. Br J Surg 2002;89:45– 49
Bringman S, Ramel S, Heikkinen TJ, et al. Tension-free inguinal hernia repair: TEP versus mesh-plug versus Lichtenstein; a prospective randomized controlled trial. Ann Surg 2003;237:142–147
Barth RJ, Burchard KW, Tosteson A, et al. Short-term outcome after mesh or Shouldice herniorrhaphy: a randomized, prospective study. Surgery 1998;123:121–126
Goldstein SL. Mechanism and metabolic characteristics of hernia formation. Probl Gen Surg 2002;19:16
Abrahamson J. Etiology and pathophysiology of primary and recurrent hernia formation. Surg Clin North Am 1998;78:953–972
Sorensen LT, Friis E, Jorgensen T, et al. Smoking is a risk factor for recurrent groin hernia. World J Surg 2002;26:397–400
Zheng H, Si Z, Kasperk R, et al. Recurrent inguinal hernia: disease of the collagen matrix? World J Surg 2002;26:401–408
Heise CP, Starling JR. Mesh inguinodynia: a new clinical syndrome after inguinal herniorrhaphy? J Am Coll Surg 1998;187:514–518
Bay-Nielsen M, Nilsson E, Nordin P, et al. Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males. Br J Surg 2004;91:1372–1376
Fränneby U, Gunnarsson U, Wollert S, et al. Discordance between the patient’s and surgeon’s perception of complications following hernia surgery. Hernia 2005;9:145–149
Bay-Nielsen M, Perkins FM, Kehlet H. Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 2001;233:1–7
Riley KD, Lilly MC, Arregui ME. Management of complications following inguinal hernia repair. Probl Gen Surg 2002;19:97–108
Burney RE, Jones KR, Coon JW, et al. Core outcomes measures for inguinal hernia repair. J Am Coll Surg 1997;185:509–515
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Beltrán, M.A., Cruces, K.S. Outcomes of Lichtenstein Hernioplasty for Primary and Recurrent Inguinal Hernia. World J. Surg. 30, 2281–2287 (2006). https://doi.org/10.1007/s00268-006-0233-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-006-0233-z