Early outcome of Lichtenstein technique for complete variety of inguinal hernia repair in a tertiary care hospital

Abstract

Background : Inguinal hernia repair is very common in day to day general surgical practice. Result of surgical repair is often satisfactory but recurrences following surgery are troublesome both for the surgeon and the patient. Lichtenstein technique is now the most widely performed technique in groin hernia repair.Objective : The aim of this study was to assess short term outcome of complete variety of inguinal hernia repair by Lichtenstein technique. Methodology :This was a prospective observational study in which 30 complete variety of inguinal hernia repairs were performed by Lichtenstein technique between January 2014 and December 2017 by same surgical team in surgery department, Holy Family Red Crescent Medical College Hospital (HFRCMCH). Patients were scheduled for follow up visits at the end of first week, third month and sixth month after operation in out-patient department. The main outcome measures were postoperative complications, early recurrence, groin pain. Result :In this study age of the patients ranged from 30 years to 78 years, the mean age was 51.93 (±SD 10.12) years. Most of the hernia were of indirect type 18(60%) followed by direct type 9(30%). In indirect type (55.6%) of the hernias was right sided and the rest (44.4%) were left sided. On an average each operation lasted for 1.18 hours and oral feeding started 12.69 hours after the operation, Postoperative mean hospital stay that was 2.27 days. Postoperative complications were 2(6.7%) had a prolonged recovery and presented with abdominal distention after operation and 3(10%) patients developed postoperative urinary retention. Scrotal haematoma formation was observed in 2(6.7%) cases and other post operative complications were local haematoma or seroma formation in incision site, periincisional skin echymosis, postoperative pyrexia, superficial wound infection and post operative pain were found in 1 (3.3%) cases. Regarding outcome no recurrence or mesh rejection or mesh infection were observed within short time postoperative follow up period. Conclusion :In this study no recurrence or mesh rejection or mesh infection were observed within short time postoperative follow up period and patient's compliance was good with minimum morbidity. Therefore, Lichtenstein's technique of inguinal hernia repair considered as a safe and effective procedure.

Evaluation of clinico-epidemiological profile and associated risk factors of inguinal hernia. A Prospective observational study

“…It is reflected very well in this study where most of the patients (61%) were in low saocioecenomic status, 24% and 15% were in middle and higher socioecenomic catagories respectively. In this study, right inguinal hernias were more common than left, ratio 1.08:1 and only 6% cases were bilateral which correlates with study done by Mukesh sangwan [8] et al showed 1.45:1 and with also some other studies [7,5,17] In our study, direct hernias, indirect pantaloons hernias seen were in 57%, 30%, 7% study patient respectly and the present study correlated well with Burcharth et al [4] In our study population, older age (50%) and smoking (39%) were the most common risk factors present. History of prostatism (19%), heavy weightlifting(21%),constipation(17%) were the other common risk factors for the development of inguinal hernia in our study(Figure 5) that correlates with study of Robindera Kour et al [10] and some other studies 3,5,7 . Smoking was established as an independent risk factor for hernia development with Malviya et al [1] reporting 30.6%10 of their study.…”

“…Hernia is a Latin term that is defined as an "abnormal protrusion of a viscus or part of a viscus through a normal or abnormal opening in the wall of its containing cavity". 1Still now nguinal hernia repair is second most common general surgical operations worldwide that account for about 10-15% of all surgical procedures [7,17] . It is very common in men with lifetime risk of 27% and 3% for women, thus 1 in 4 men has the risk of developing the condition.…”

“…It is very common in men with lifetime risk of 27% and 3% for women, thus 1 in 4 men has the risk of developing the condition. and incidence increase with increase of age in man [2,7] Though exact data of hernia surgery in Bangladesh is unavailable, but with the average global incidence of hernia surgery being 3 per 1000 population yearly [4] , Bangladesh with a population of 180 million where more than half million hernia surgeries performed every year. Very often hernia as a disease is ignored specially underdeveloped and developing countries as they may remain asymptomatic for prolonged periods, the severity of the condition is often overlooked and ultimately it results higher mortality as high as 7% in emergency surgeries [1,7,17] World health organization (2002) reported that inguinal hernias are sources of social stigma [4,7] .…”

“…~ 32 ~ It lower the chances for employment, create sexual problems, physical deformation, loss of work, low self-esteem or confidence [3,5,7] People who are living with victims of inguinal hernia were reported to have not only poor health-seeking behavior but also they were negligent about their conditions, ignorant about the life threatening side effects or complications associated with their conditions. Sometimes cultural, educational factors and economic constraints may prevent the realization of illness and suppress proper utilization of available health services.…”

“…So, in developing countries, quite a considerable percentage of inguinal hernia is not repaired that leads to a higher incidence of morbidity and mortality. Inguinal hernias may be congenital or acquired [7] Several hypotheses regarding the etiology of inguinal hernia have been proposed. In male increased abdominal pressure, preexisting abdominal muscles weakness, constipation, prostatism, chronic cough, heavy weight lifting, obesity, smoking, aging, pelvic fractures and trauma, connective tissue diseases, and systemic illnesses and in females, obesity, pregnancy, and operative procedures have been proposed and well-known risk factors that commonly contribute to the formation of inguinal hernia.…”