Darning Hernioplasty vs. Mesh Hernioplasty- A Non-Randomised Controlled Trial With 3 Years Followup in a Tertiary Care Hospital, Rajahmundry, Andhra Pradesh, India

Abstract

BACKGROUNDInguinal hernias are protrusions of abdominal cavity contents through the inguinal canal. Inguinal hernias are the commonest of all hernias. Surgery is the definitive treatment for hernia. This study aims to compare the results of costly, yet popular Lichtenstein mesh plasty with darning technique for inguinal hernia. MATERIALS AND METHODSStudy Design and Setting: A non-randomised controlled trial with 100 patients of inguinal hernia was conducted in a tertiary care hospital, Rajahmundry between May 2010 -May 2013 (3 years). All patients who attended the surgical OPD during May 2010 to May 2013 (3 years) and satisfied the inclusion criteria were included in the study. The patients were randomly allocated/ treated with darn hernioplasty and mesh hernioplasty alternatively. Both the techniques were compared in terms of duration of surgery, cost and postoperative complications. Results were expressed as percentages, mean and standard deviation. Independent t-test was used to analyse the difference among continuous variables. A P value of < 0.05 is considered statistically significant. RESULTSMost of them 44 (44%) were in the age group of 25 to 39 years. Mean age was 36 years with a standard deviation of +/-2.41. Hernia was seen more commonly among males, 98 (98%). Indirect hernia was more common, 73 (73%). Mean duration for darn repair was 40 minutes compared to 68 minutes for mesh repair. The difference in duration of surgery between two techniques was statistically significant (p < 0.05). The cost for mesh repair is more compared to darn repair. Following darn repair 6 (12%) developed postoperative complications and most common being haematoma 3 (6%), while with mesh repair 7 (14%) had postoperative complications and most common being wound infection 3 (6%). CONCLUSIONDarn repair is superior to mesh repair of inguinal hernia in terms of cost effectiveness, duration of surgery with similar postoperative outcome. KEYWORDSInguinal Hernia, Darn Repair, Mesh Repair, Comparison, Andhra Pradesh, India. HOW TO CITE THIS ARTICLE:Rao GB, Rao KLN, Nayak SR, et al. Darning hernioplasty vs. mesh hernioplasty-a non-randomised controlled trial with 3 years followup in a tertiary care hospital, Rajahmundry, Andhra Pradesh, India. J. Evolution Med. Dent. Sci. 2017;6(86):5947-5950, DOI: 10.14260/jemds/2017/1294 BACKGROUND Hernia term is derived from the Latin word for rupture. Inguinal hernia repair accounts for 10% -15% of all surgical procedures and constitutes 73% of all external hernia. (1,2) Surgery is indicated in many hernias to prevent complications. These patients must be thoroughly evaluated before hernia repair. (2) Fortunately, most inguinal hernias are repaired electively to prevent strangulation. (3)