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
Risk of recurrence 5 years or more after primary Lichtenstein mesh and sutured inguinal hernia repair. BJS 2007; 94: 1038-1040.
Published: 2nd July 2007
Authors: T. Bisgaard, M. Bay‐Nielsen, I. J. Christensen, H. Kehlet
Background
The risk of recurrence of inguinal hernia within 5 years of repair is lower after mesh than sutured repair in men, but no large‐scale studies have compared the risk of recurrence beyond 5 years.
Method
The Danish Hernia Database prospectively collects data on almost all primary inguinal hernia repairs in men (older than 18 years). This study used data recorded over 8 years, analysing reoperations for recurrent hernia in the intervals 0–30 months, 30–60 months and 60–96 months after operation.
Results
The reoperation rate was significantly lower after Lichtenstein open mesh repairs than open sutured repairs (Cox hazard ratio (HR) 0·45 (95 per cent confidence interval (c.i.) 0·39 to 0·51) for 0–30 months after surgery; HR 0·38 (95 per cent c.i. 0·29 to 0·49) for 30–60 months). In 13 674 primary inguinal hernia repairs with an observation interval of 5 years or more, the risk of reoperation after Lichtenstein repair was a quarter of that after sutured repair (HR 0·25 (95 per cent c.i. 0·16 to 0·40) for 60–96 months after surgery). After 5 years, the reoperation rate increased continuously after sutured repair but not after mesh repair.
Conclusion
Lichtenstein mesh repair for inguinal hernia prevented recurrence beyond 5 years after the primary operation, but sutured repair did not. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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