Abstract
Objective:To examine the long-term outcomes such as recurrence, foreign body feeling and chronic pain of titanium-coated mesh (TCM) versus standard polypropylene mesh (PM) after Lichtenstein repair (LR).Methods:In this retrospective cohort study, patients who underwent TCM and PM in LR were evaluated between May 2014 and January 2018 at Ordu University Training and Research Hospital in Turkey. Primary outcomes (age, gender, body mass index, smoking habits, comorbid diseases, American Society of Anesthesiologists score, hernia type, side of hernia, duration of hernia presentation and operative time) and secondary outcomes (surgical site occurence, recurrence, foreign body feeling and chronic pain) were analyzed. Patients were divided into two groups according to the mesh elected (TCM and PM); titanium group (TG) and polypropylene group (PG), respectively.Results:In this study, 221 patients were analyzed; TCM was used in 72 (32.6%) patients and PM was used in 149 (67.4%) patients. No difference was found between groups in terms of primary outcomes (p>0.05). In the analysis of secondary outcomes, surgical site occurence was similar in both groups (p>0.05). Recurrence was observed in 1.39% (n=1) of TG and 2.01% (n=3) of PG. No difference was found between groups in terms of recurrence (p=0.606). Foreign body feeling was observed in 15.3% (n=11) of TG and 27.5% (n=41) of PG. Chronic pain was observed in 4.2% (n=3) of TG and 12.8% (n=9) of PG. Significant differences were found between groups in terms of chronic pain and foreign body feeling (p=0.046 and p=0.044, respectively).Conclusion:The result of this study shows that in LR, TCM leads to less foreign body feeling and chronic pain than PM. However, there was no difference in terms of recurrence between these meshes.
Highlights
Inguinal hernia repair is a frequent operation in general surgery but recurrence, chronic pain and foreign body feeling after an operation are the issues that should be resolved by surgeons.[1,2]
No significant difference was found in terms of recurrence between groups (p>0.05), and foreign body feeling and chronic pain were significantly lower in titanium group (TG) than polypropylene group (PG) (p
In 2019 Yang et al found that titanium-coated mesh (TCM) lead to less foreign body feeling than highweight polypropylene mesh (PM) in laparoscopic inguinal hernia repair.[12]
Summary
Inguinal hernia repair is a frequent operation in general surgery but recurrence, chronic pain and foreign body feeling after an operation are the issues that should be resolved by surgeons.[1,2] Lichtenstein repair (LR), one of the very frequently used methods, is a golden standard method in open inguinal hernia repair.[3]. Meshes have some advantages such as high tensile strength and cost-efficiency, they have complications such as seroma, foreign body feeling and chronic pain. There is no clear information about the effects of TCM on recurrence, foreign body feeling and chronic pain in LR. The aim of this study was to assess the recurrence, foreign body feeling and chronic pain after LR using TCM
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