DESARDA'S VS LICHTENSTEIN'S TECHNIQUE IN INGUINAL HERNIA REPAIR : A COMPARATIVE STUDY

Abstract

Background: About 75% of abdominal wall hernias are inguinal hernias, with a lifetime risk of 27% in men and 3% in women. Lichtenstein's hernia repair was favored and became the gold standard of open tension-free hernia repair. However, the use of synthetic prostheses can result in new clinical problems. In order to reduce the incidence of complications and postoperative dysfunction, the tissue-based groin herniorrhaphies has re-attracted the attentions in recent years. In 2001, Dr. Mohan Desarda proposed a solution which involves use of a strip of external oblique aponeurosis to strengthen the posterior wall of the inguinal canal.(1) To compare the Aim: post-operative complications, short-term outcomes and recurrence rate for one year between Lichtenstein's and Desarda's technique. Materials And Methods: This is a prospective, randomised study (ODD – EVEN basis) in GSVM Medical College, LLR & Associated Hospitals, Kanpur (UP). 100 patients in two groups with 50 patients in each group: Group A (Lichtenstein's repair) and Group B (Desarda's repair). Outcomes were assessed on the basis of recurrence (with regular follow ups at one month, three months, six months and one year); Operating time; Cost of procedure in total; Post operative course (post operative pain, induration, redness of operated site, post operative wound infection rate. discharge time or hospital stay). Out of 100 patients majority of Results: patients were having right sided indirect hernia. The duration of the surgery was statistically less in Desarda group (53.68±20.21) than Lichtenstein (68.4±53.68) (p<0.05). The pain was signicantly lesser in Desarda group than Lichtenstein groups (p<0.05). The duration of hospital stay was signicantly lower in Desarda group (p<0.05). Seroma Formation was major complication in Lichtenstein group followed by Hematoma Formation, Surgical site infection and recurrence whereas in Desarda group seroma formation was found in only 2 patients and recurrence was in only 1 patient (association of complications in both groups was found to be statistically signicant (p<0.05)). The result of the Conclusion: inguinal hernia treatment with Desarda technique are comparable to results of Lichtenstein surgery. Desarda technique do not use mesh, this makes Desarda repair cost effective and easy to learn. Patients after Desarda's procedure get sooner ambulatory than Lichtenstein mesh repair.(2,3). Recurrence rate is more in Lichtenstein's group although the association was insignicant.(3,4). Hence, Desarda's no mesh repair is favorably comparable with Lichtenstein's mesh repair.