This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Randomized trial of Lichtenstein versus Shouldice hernia repair in general surgical practice. BJS 2002; 89: 45-49.
Published: 5th November 2002
Authors: P. Nordin, P. Bartelmess, C. Jansson, C. Svensson, G. Edlund
Background
The aim of the present randomized trial was to compare the Shouldice procedure and the Lichtenstein hernia repair with respect to recurrence rate, technical difficulty, convalescence and chronic pain. A further aim was to determine to what extent general surgeons in routine surgical practice were able to reproduce the excellent results reported from specialist hernia centres.
Method
Three hundred patients with primary inguinal hernia were randomized to either a Shouldice repair or to a tension‐free Lichtenstein repair. In a pretrial training programme the five participating general surgeons were taught to perform the two techniques in a standard manner. Follow‐up was performed after 8 weeks, 1 year and 3 years. The last examination was performed by an independent blinded assessor.
Results
There was a significant difference in operating time in favour of the Lichtenstein technique. After a follow‐up of 36–77 months seven recurrences were found in the Shouldice group (95 per cent confidence interval (c.i.) 1·3 to 8·1) and one in the mesh group (95 per cent c.i. 0·0 to 2·0). Chronic groin pain was reported by 4·2 and 5·6 per cent in the Shouldice and Lichtenstein groups respectively. It was characterized as mild or moderate in all except two patients who had the Shouldice operation.