Abstract

*Dr. Purujit Choudhury and Dr. Santoshkumar Dodamani

ABSTRACT

Background: Hernias are among the oldest known afflictions of mankind. 75% of all abdominal wall hernias are found in the groin. Of all groin hernias, 95% are hernias of the inguinal canal. Inguinal hernia is a common disorder affecting approximately 5 to 10% of the adult population worldwide. Worldwide more than 20 million patients undergo inguinal hernia repair annually and it is one of the most frequently performed operations in general surgery. Tension-free repair (Lichtenstein mesh repair) has been established as the method of choice for the management of uncomplicated inguinal hernia. Aim: is to study the outcomes of techniques with regards to Operating time, Ambulation time, Duration of hospital stay, Postoperative pain & complications and to look for any recurrence with regular follow up after 1 week, at one month, three months, six months and 12 months. Materials and Methods: This is a prospective study carried out in the department of surgery of Guwahati medical college. This study includes 100 patients of which 50 underwent Modified Bassini repair and 50 underwent Lichtenstein mesh repair. Hernia was diagnosed by clinical and onUSG finding. Results: The highest incidence is in 51-60 age group (30%) & mean age in Lichtenstein mesh repair (LMR) and Modified Bassini repair (MBR) group are 42.32 yrs and 43.46 yrs respectively, all are male patients, majority of patients were smokes (60 out of 100 patients), seen commonly among the manual labourers and the farmers, accounting for 27% and 22% respectively, 74% presented with only swelling and 26% presented with both pain and swelling, with higher incidence of right side indirect inguinal hernia (62 out of 100). The mean duration of surgery in LMR was 42.66 minutes whereas in MBR it was 48.44 minutes. 18 patients of LMR & 20 patients of MBR had mild pain. 17 patients of LMR and 28 patients of MBR had moderate pain. Seroma was found 8 cases in LMR and 1 case in MBR. Incidence of haematoma was 7(14%) in LMR and 1(2%) in MBR group. Chronic pain occurs in 16% of MBR group and only 4 % in LMR group. 1 recurrence was noted in the Modified Bassini repair group. The ambulatory time was (3.12+/-0.87 days) days in LMR and(3.98+/-0.82 days) days in MBR. The mean period of hospitalization was 4.92 days in case of LMR and 5.86 days in case of MBR. Mean day of return to normal activity is n MBR and LMR respectively 12.26+/-3.75 and 12.94+/-3.49days days. Conclusions: Surgery is the mainstay in treatment of inguinal hernias. Correction of precipitating conditions is important for successful outcome. Lichtenstein tension free mesh repair was the commonest and gold standard of procedure undertaken. However, tissue repair has the scope to become an alternate procedure in emergency settings where the use of mesh is contraindicated or those patients who disagree the use of mesh.