A Randomized Trial Comparing Lichtenstein Repair and No Mesh Desarda Repair for Inguinal Hernia: A Study of 1382 Patients

Background: The objective of this study is to compare the outcomes of Lichtenstein repair and no mesh Desarda repair for inguinal hernia.
Methods: This is a prospective randomized trial of 1382 patients having 1461 hernias operated from January 2002 to December 2011.704 patients were operated using Lichtensteinrepairand 678 using Desardarepair. The variables like age, sex, type of hernia, duration of surgery, pain on the first, third and fifth day, hospital stay, complications, re-explorations, morbidity and time to return to normal activities were analyzed. Follow up period was from 1-10 years (median 6.5 years).
Results: There were no significant differences regarding age, sex, type of hernia, and pain in both the groups. The operation time was 48 minutes in Desarda group and 39 minutes in the Lichtenstein group that is significant (p<0.05).The recurrence was 0.5 % in Desarda group and 0.4% in Lichtenstein group. There were 8 cases of infection to the polypropylene mesh in the Lichtenstein group, 3 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (7.5%) as compared to Desarda group (3.4%). The mean time to return to normal routine non-strenuous work in the Desarda group was 8.26 days v 12.58 days in the Lichtenstein group. The mean hospital stay was 29 hrs. in Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized.
Conclusions: Desarda repair scores significantly over the Lichtenstein repair. Morbidity due to complications and re-explorations for sepsis were significantly higher in mesh group. Period of return to normal work was also less in the Desarda group. No mesh Desarda repair is a better choice as compared with the Lichtenstein mesh repair.