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Tension-free repair versus Bassini technique for strangulated inguinal hernia: A controlled randomized study.
Int J Surg. 2008 Aug; 6(4):302-5.IJ

Abstract

By Evidence Based Medicine (EBM) principles, several meta-analyses concluded that use of mesh is superior to the non-mesh operations in inguinal hernia surgery. Wound infection is a potential complication of all hernia repairs and deep-seated infection involving an inserted mesh may result in chronic groin sepsis. In the event of incarcerated or strangulated hernias, however; placement of prosthetic material is presumed to increase that risk of infection.

AIM

Aim of the study is to compare the outcome of tension-free mesh repair to Bassini technique used to treat strangulated inguinal hernia.

PATIENTS AND METHODS

In the period from May 2004 to December 2006, 54 patients were submitted to emergency operation because of strangulated inguinal hernia. The patients were randomized into two groups (27 patients in each group). Group A patients underwent open tension-free anterior repair utilizing a monofilament polypropylene mesh according to Lichtenstein "tension-free" technique, whereas group B patients underwent Bassini technique. Mesh hernioplasty was not attempted in patients with preoperative peritonitis, inflammatory hernia and for those in whom bowel resection was perfumed for ischemic necrosis caused by strangulated inguinal hernia and they were excluded from the study. Assessment of the primary outcome included surgical complications and hospital stay and secondary outcome was the recurrence of hernia.

RESULTS

Postoperative complication rate did not differ significantly between the two groups. Postoperative hospital stay was also significantly longer in group B compared to group A (5+/-3.4 days versus 3+/-2.1 days, p<0.01). During the follow-up, (mean 22+/-6months), three patients had recurrence after Bassini operation (group B), but there was no recurrent hernia after mesh herniorrhaphy (group A) (0/27=0% versus 3/27=7, 11.1%, p<0.001).

CONCLUSION

The use of Lichtenstein "tension-free" technique in emergency treatment of strangulated inguinal hernia is safe, effective with an acceptably low rate of postoperative complications and without recurrence.

Authors+Show Affiliations

Department of General Surgery, Theodore Bilharz Research Institute, P.O. Box30, Imbaba, Giza 12411, Egypt. magdyelsebae@hotmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18573702

Citation

Elsebae, Magdy M A., et al. "Tension-free Repair Versus Bassini Technique for Strangulated Inguinal Hernia: a Controlled Randomized Study." International Journal of Surgery (London, England), vol. 6, no. 4, 2008, pp. 302-5.
Elsebae MM, Nasr M, Said M. Tension-free repair versus Bassini technique for strangulated inguinal hernia: A controlled randomized study. Int J Surg. 2008;6(4):302-5.
Elsebae, M. M., Nasr, M., & Said, M. (2008). Tension-free repair versus Bassini technique for strangulated inguinal hernia: A controlled randomized study. International Journal of Surgery (London, England), 6(4), 302-5. https://doi.org/10.1016/j.ijsu.2008.04.006
Elsebae MM, Nasr M, Said M. Tension-free Repair Versus Bassini Technique for Strangulated Inguinal Hernia: a Controlled Randomized Study. Int J Surg. 2008;6(4):302-5. PubMed PMID: 18573702.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tension-free repair versus Bassini technique for strangulated inguinal hernia: A controlled randomized study. AU - Elsebae,Magdy M A, AU - Nasr,Maged, AU - Said,Mohamed, Y1 - 2008/05/02/ PY - 2008/02/29/received PY - 2008/04/16/revised PY - 2008/04/25/accepted PY - 2008/6/25/pubmed PY - 2008/11/15/medline PY - 2008/6/25/entrez SP - 302 EP - 5 JF - International journal of surgery (London, England) JO - Int J Surg VL - 6 IS - 4 N2 - UNLABELLED: By Evidence Based Medicine (EBM) principles, several meta-analyses concluded that use of mesh is superior to the non-mesh operations in inguinal hernia surgery. Wound infection is a potential complication of all hernia repairs and deep-seated infection involving an inserted mesh may result in chronic groin sepsis. In the event of incarcerated or strangulated hernias, however; placement of prosthetic material is presumed to increase that risk of infection. AIM: Aim of the study is to compare the outcome of tension-free mesh repair to Bassini technique used to treat strangulated inguinal hernia. PATIENTS AND METHODS: In the period from May 2004 to December 2006, 54 patients were submitted to emergency operation because of strangulated inguinal hernia. The patients were randomized into two groups (27 patients in each group). Group A patients underwent open tension-free anterior repair utilizing a monofilament polypropylene mesh according to Lichtenstein "tension-free" technique, whereas group B patients underwent Bassini technique. Mesh hernioplasty was not attempted in patients with preoperative peritonitis, inflammatory hernia and for those in whom bowel resection was perfumed for ischemic necrosis caused by strangulated inguinal hernia and they were excluded from the study. Assessment of the primary outcome included surgical complications and hospital stay and secondary outcome was the recurrence of hernia. RESULTS: Postoperative complication rate did not differ significantly between the two groups. Postoperative hospital stay was also significantly longer in group B compared to group A (5+/-3.4 days versus 3+/-2.1 days, p<0.01). During the follow-up, (mean 22+/-6months), three patients had recurrence after Bassini operation (group B), but there was no recurrent hernia after mesh herniorrhaphy (group A) (0/27=0% versus 3/27=7, 11.1%, p<0.001). CONCLUSION: The use of Lichtenstein "tension-free" technique in emergency treatment of strangulated inguinal hernia is safe, effective with an acceptably low rate of postoperative complications and without recurrence. SN - 1743-9159 UR - https://www.unboundmedicine.com/medline/citation/18573702/Tension_free_repair_versus_Bassini_technique_for_strangulated_inguinal_hernia:_A_controlled_randomized_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1743-9191(08)00062-9 DB - PRIME DP - Unbound Medicine ER -