Ahmadinejad Izadmehr, Jalali Ahmad, Ahmadinejad Mojtaba, Soltanian Ali, Ahamdinejad Yasmina, Shirzadi Alireza, Chaghamirzayi Pouria
Medical Student, Students' Scientific Research Center, Tehran University of Medical Science, Tehran, Iran.
General Physician, Alborz University of Medical Science, Karaj, Iran.
Surg Open Sci. 2024 Jan 15;17:70-74. doi: 10.1016/j.sopen.2024.01.001. eCollection 2024 Jan.
Inguinal hernia repair is the most frequent operation in general surgery. The chance of a person having to undergo an inguinal hernia operation during his/her life is quite high, 27 % in men and 3 % in women. European Hernia Society guidelines state that the Lichtenstein technique (mesh-based repair) is the standard treatment of elective inguinal hernia in adults. Some authors consider the Shouldice technique (tissue-based repair) the best conventional method for open hernia repair. In this study, we compared these two methods.
In This randomized study, 452 patients were randomly allocated into 2 groups. 51 patients were lost during follow-up period and were excluded from further analysis in the study. Finally, the analyzed patients were 183 patients in Shouldice technique group and 218 patients in Lichtenstein technique group. All patients were examined after 1 week, 1, 3 months, 1, 2, and 3 years after the operation date.
After 3 years follow up Recurrence of hernia in Shouldice technique group was 7.1 % and in Lichtenstein technique group was 3 % with significant differences (-value 0.006). No statistically significant differences were found between the groups in wound infection, Seroma, hematoma, Hydrocele, Bladder damage, chronic pain in the inguinal region, and Patient Satisfaction level after surgery.
It seems that inguinal hernia treatment by the Lichtenstein technique is better than the Shouldice technique in elective patients.
腹股沟疝修补术是普通外科最常见的手术。一个人一生中不得不接受腹股沟疝手术的几率相当高，男性为27%，女性为3%。欧洲疝学会指南指出，利希滕斯坦技术（基于补片的修补术）是成人择期腹股沟疝的标准治疗方法。一些作者认为肖尔代斯技术（基于组织的修补术）是开放疝修补术的最佳传统方法。在本研究中，我们比较了这两种方法。
在这项随机研究中，452例患者被随机分为两组。51例患者在随访期间失访，被排除在本研究的进一步分析之外。最终，分析的患者为肖尔代斯技术组183例和利希滕斯坦技术组218例。所有患者在术后1周、1、3个月、1、2和3年进行检查。
随访3年后，肖尔代斯技术组疝复发率为7.1%，利希滕斯坦技术组为3%，差异有统计学意义（P值0.006）。两组在伤口感染、血清肿、血肿、鞘膜积液、膀胱损伤、腹股沟区慢性疼痛和术后患者满意度水平方面未发现统计学显著差异。
对于择期患者，利希滕斯坦技术治疗腹股沟疝似乎优于肖尔代斯技术。
