Effect of Mesh Type, Surgeon and Selected Patients' Characteristics on the Treatment of Inguinal Hernia with the Lichtenstein Technique. Randomized Trial

Introduction: Though not entirely free of complications, the Lichtenstein technique is still considered the "gold standard" for inguinal hernia repair due to the low recurrence rate.

Aim: In our study we determined the effect of mesh type, surgeon and selected patients' characteristics on treatment results. The latter were determined by the frequency of early complications, recovery time and return to normal activities, chronic pain and hernia recurrence.

Material And Methods: Tension-free hernia repair with the Lichtenstein technique was performed in 149 male patients aged 20-89 years randomized to two trial groups. One group comprised 76 patients with heavyweight non-absorbable polypropylene mesh (HW group) and the other included 73 patients with lightweight partially absorbable mesh (LW group). The control schedule follow-up took place on the 7(th) day as well as in the 3(rd) and 6(th) month after the operation. Statistical analysis was performed with multi-factor regression models.

Results: In the LW group patients returned to normal activity faster (p = 0.031), experienced less intensive chronic pain (p = 0.01) and expressed higher treatment satisfaction (p = 0.024) than the patients from the HW group. The type of mesh had an insignificant influence on the risk of early complications and hernia recurrence. Statistically significant differences were observed however with regard to surgeon, type and hernia duration, patient's general condition and body mass.

Conclusions: Both types of mesh are equally effective for prevention of hernia recurrence. Lightweight partially absorbable meshes are more beneficial to patients than the heavyweight non-absorbable type. The surgeon and patients' characteristics have a significant impact on the treatment outcome.