A Randomized Trial. Comparing Herniorrafia Modifield Desarda Repair and Hernioplastia Lichtenstein Repair for Inguinal Hernia (Study of 1242 Patients)

Introduction: The objective of this study is to compare the outcomes of Modified Desarda repair no mesh and Lichtenstein repair for inguinal hernia.

Patients and Methods: This is a prospective randomized controlled trial study of 1242 patients having 1313 hernias operated from January 2008 to December 2018. 640 patients were operated using Lichtenstein repair and 602 using Desarda repair. The variables like age, sex, location, type of hernia, tolerance to local anesthesia, 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, location, type of hernia, and pain in both the groups. The operation time was 52 minutes in Modified Desarda group and 42 minutes in the Lichtenstein group that is significant (p<0.05). The recurrence was 0.0% in Modified Desarda group and 0.3% in Lichtenstein group. But, there were 8 cases of infection to the polypropylene mesh in the Lichtenstein group, 2 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (7,0%) as compared to Modified Desarda group (3.6%). The mean time to return to work in the Modified Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. in Modified Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized.

Conclusions: Modified Desarda repair scores significantly over the Lichtenstein repair in all respects including re-explorations and morbidity. Modified Desarda repair is a better choice as compared with Lichtenstein repair.

Keywords: Desarda Repair; Inguinal Hernia; Lichtenstein Repair; Randomized Trial.