Perioperative outcomes using Lichtenstein-type open hernioplasty versus Nyhus-type preperitoneal hernioplasty in inguinal hernia: a comparative study with 1-year follow-up

Abstract

Background Inguinal hernia are the most common defect of the abdominal wall in 75% and their treatment consists of surgical repair. The technique of choice is laparoscopic because of its overall benefits. However, when this is not available, open approaches may be a viable option. Currently the most commonly used open techniques are Lichtenstein and Nyhus. However, there are no long-term studies that have compared outcomes between these two techniques. Methods Retrospective comparative study that included patients undergoing open inguinal hernia correction with mesh, using Lichtenstein-type open hernioplasty versus Nyhus-type preperitoneal hernioplasty, in two centers in Bogota, Colombia, during a period of two years. Frequencies and percentages were calculated. A bivariate analysis was performed to compare groups, according to the complications presented between the two techniques. Results 193 patients were included, of whom 53.36% were men and 58.03% (n = 112) were approached with the Nyhus technique. Non-absorbable suture fixation was performed in 100% of patients. Among the main complications, seroma (5.18%), pain (4.14%), bleeding (2.07%), recurrence (10.88%) and reoperation (0.51%) were observed, of which only recurrence showed a statistically significant difference, being lower in the Nyhus approach (3.57% vs. 20.67%; p < 0.001). No patients died. Conclusions Both Nyhus- and Lichtenstein-type hernioplasty techniques were shown to cause a low incidence of postoperative complications with zero mortality, with significantly lower recurrence using the Nyhus technique up to 1 year postoperatively.