Inguinal Hernia repair by Darn versus Lichtenstein repair

Abstract

Background: Tension free inguinal hernia repair like darning is commonly practiced in general surgery in our set up but mesh repair is getting popularity for the last few years. Aim: Two techniques are compared with respect to effectiveness, duration of surgery, post- operative complications, duration of hospital stay, pain free early return to normal physical activity and work. Study Design: It is a randomadised prospective comparative study. Place and duration of study: The study was conducted in surgical unit, Amna Inayat medical college Shaikhupura from May 2012 to April 2016. Methodology: A total of eighty four patients were included in the study. They were randomly divided in two groups. Darn group (D) and Lichtenstein - mesh group L. Group D has forty (n= 40) patients and group (L) has forty four (n=44) patients. We assessed the post operatively for a follow up period of 20 months for effectiveness of the technique, post operative complications, duration of hospital stay and pain free early return to normal physical activity and work. Results: A total of 84 patients were divided into two groups. Darn group (D) had 40 patients and Lichtenstein mesh group L had 44 patients. Two techniques were compared with respect to duration of surgery, post operative recovery, post operative complications like post operative pain which was 8(20%) in group D and 16(36.36%) in group L with p value 0.10, urinary retention 3(7.5%) in group (D) and 5(11.36%) with p value 0.47, inguinoscrotal swelling 3(7.5%) in group (D) and 6(13.63%) in group (L) with p – value 0.31, post operative wound infection no patient developed wound infection in group (D) while in group L 4(9.09%) P value 0.04. No any patient developed orchitis, osteitis pubis in any group. No patients developed recurrence of inguinal hernia in any group over a period of two years follow up. The mean hospital stay in group D was 2.37±1.38 days while it was 2.72±1.56 days in group L. Most of the patients in both groups returned to the normal activity on first post operative day, in group (D) 38(95%) and 34(77.27%) in group L Conclusion: There is no gross statistical difference between Darn repair and Lichtenstein repair. Darn repair is still better with respect to its simplicity, less inguinoscrotal swelling, less surgical site infection, cost effective and surgeons are used to perform it at all level of health care centers.