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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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.
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.
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.
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.
KeywordsDesarda Lichtenstein Inguinal hernia Randomized controlled trial Review Meta-analysis
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.
Compliance with ethical standards
Conflict of interest
No conflict of interest to be declared by the authors.
This article did not require ethical approval of any kind.
Human and animal rights
This article does not contain any studies with human participants or animals performed by any of the authors.
This article does not include patients, and therefore informed consent was not applicable.
- 3.Scott NW, McCormack K, Graham P, Go PM, Ross SJ, Grant AM (2002) Open mesh versus non-mesh for repair of femoral and inguinal hernia. Cochrane Database Syst Rev (4):CD002197Google Scholar
- 13.Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and metaanalyses of studies that evaluate healthcareinterventions: explanation and elaboration. BMJ 21(339):b2700CrossRefGoogle Scholar
- 16.Rodríguez P, Herrera P, Gonzalez O, Alonso J, Blanco H (2013) A randomized trial comparing lichtenstein repair and no mesh desarda repair for inguinal hernia: a study of 1382 patients. East Central Afr J Surg 18(2):18–25Google Scholar
- 18.Bhatti I, Ishaqu H, Ahmad Z, Dar U (2015) Desarda’s versus lichtenstein technique of hernia repair. Pak J Med Health Sci 9(4):1331Google Scholar
- 24.National Institute of Clinical Excellence(NICE) (2004) Final appraisal determination, laparoscopic surgery for inguinal hernia repair. LondonGoogle Scholar
- 31.Losanoff JE, Millis JM (2006) Aponeurosis instead of prosthetic mesh for inguinal hernia repair: neither physiological nor new. Hernia 10(2):1981–1999Google Scholar
- 34.Desarda MP, Ghosh DN (2006) Comparative study of open mesh repair and Desarda’s nomesh repair in a district hospital in India. East Central Afr J Surg 11(2):18–34Google Scholar
- 40.(1986) Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy. Pain Suppl 3:S1-226Google Scholar