Saud, J., Fadhil, M. (2023). A prospective comparison study between lechtenstein open anterior polypropylene onlay mesh”OAPOM” and modified lechtenstein (chastan and Basrah technique). Alustath, 29(2), 113-122. doi: 10.33762/bsurg.2023.144058.1061
Jasim Dager Saud; Muataz Fathullh Fadhil. "A prospective comparison study between lechtenstein open anterior polypropylene onlay mesh”OAPOM” and modified lechtenstein (chastan and Basrah technique)". Alustath, 29, 2, 2023, 113-122. doi: 10.33762/bsurg.2023.144058.1061
Saud, J., Fadhil, M. (2023). 'A prospective comparison study between lechtenstein open anterior polypropylene onlay mesh”OAPOM” and modified lechtenstein (chastan and Basrah technique)', Alustath, 29(2), pp. 113-122. doi: 10.33762/bsurg.2023.144058.1061
Saud, J., Fadhil, M. A prospective comparison study between lechtenstein open anterior polypropylene onlay mesh”OAPOM” and modified lechtenstein (chastan and Basrah technique). Alustath, 2023; 29(2): 113-122. doi: 10.33762/bsurg.2023.144058.1061

A prospective comparison study between lechtenstein open anterior polypropylene onlay mesh”OAPOM” and modified lechtenstein (chastan and Basrah technique)

Basrah Journal of Surgery
Article 12, Volume 29, Issue 2 - Serial Number 58, December 2023, Pages 113-122    PDF (1011.65 K)
Document Type: Original Article
DOI: 10.33762/bsurg.2023.144058.1061
Authors
Jasim Dager Saud* 1; Muataz Fathullh Fadhil2
1FICMS,CABS, FRCS, FACS, D.MAS. Consultant and Chief Surgeon ,Basrah Teaching Hospital
2Department of surgery, Basrah Teaching Hospital
Abstract
Background:
Lichtenstein in the 1980, employed a mesh piece to the inguinal canal`s floor. It showed superior results compared to previous tissue-based repairs. It is gold standard for open hernia repair with recurrence rate at 5 years <4%, with risk of severe chronic pain at 3 years = 6%. The Chastan technique, in 2005, was developed to improve the Lichtenstein technique. He was using different dissection and different mesh implantation (small grips covering whole of one side of mesh to secure immediate fixation around the cord with a self-gripping flap). Here in Basrah in 2016, we try to improve the Lichtenstein technique by using the same dissection of Chastan but differ from Chastan in applying of mesh. We used polypropylene mesh in three techniques.
Objective
A comparative assessment of operative time, early and late postoperative complications of surgery for inguinal hernia repair using lichteinstien, Chastan and Basrah techniques.

Methods:
Between December 2016 and December 2019, a total of 150 male adult patients with primary inguinal hernia were included according to inclusion criteria of our study. Patients were divided into 3 groups each group contain 50 patients which undergo Lichteinstien (L), Chastan(C) and Basrah(B) techniques respectively: All patients followed up to two years. The operative time, early and late postoperative complication were compared among three groups.
Result:
The 3 groups were similar in terms of age, sex, comorbidities, BMI, ASA classification, types of inguinal hernia (Nyhus classification). There is no significate difference in terms of operative time (p value=0.954),24-h VAS score, length of hospital stays (LOS) and return to work (RTW), (p value=0.607,0.206,0.651 respectively). Seroma formation, chronic pain and recurrence rate were lower in Basrah and Chastan than Lichtenstein.
Conclusion:
Basrah and Chastan techniques show better results than Lichtenstein technique in terms of chronic pain, seroma formation and recurrence rate.
Keywords
Inguinal hernia repair,,; ,،lichtenstein,,; ,،Chasten,,; ,،Basrah method
References
  1. Amid PK, Shulman AG, Lichtenstein IL. The Lichtenstein open "tension-free" mesh repair of inguinal hernias. Surg Today. 1995;25(7):619-625. doi:1007/BF00311436
  2. Kurzer M, Belsham PA, Kark AE. The Lichtenstein repair. Surg Clin North Am. 1998;78(6):1025-1046. doi: 1016/s0039-6109(05)70367-4
  3. Shulman AG, Amid PK, Lichtenstein IL. A survey of non-expert surgeons using the open tension-free mesh patch repair for primary inguinal hernias. Int Surg. 1995;80(1):35-36.
  4. McIntosh A, Hutchinson A, Roberts A, Withers H. Evidence-based management of groin hernia in primary care--a systematic review. Fam Pract. 2000;17(5):442-447. doi:1093/fampra/17.5.442
  5. Lafferty PM, Malinowska A, Pelta D. Lichtenstein inguinal hernia repair in a primary healthcare setting. Br J Surg. 1998;85(6):793-796. doi:10.1046/j.1365-2168.1998.00706.x
  6. Alfieri S, Amid PK, Campanelli G, et al. International guidelines for prevention and management of post-operative chronic pain following inguinal hernia surgery. Hernia. 2011;15(3):239-249. doi:1007/s10029-011-0798-9
  7. Kehlet H. Chronic pain after groin hernia repair. Br J Surg. 2008;95(2):135-136. doi:1002/bjs.6111
  8. Fränneby U, Sandblom G, Nordin P, Nyrén O, Gunnarsson U. Risk factors for long-term pain after hernia surgery. Ann Surg. 2006;244(2):212-219. doi: 1097/01.sla.0000218081.53940.01
  9. Philippe Chastan, Tension-free inguinal Hernia repair: A Retrospective Study on 3000 Cases in One Center. Int Surg [2005],90(1):48- 52.
  10. Mangram A.J., Horan T.C., Pearson M.L., Silver L.C., Jarvis W.R. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am. J. Infect. Control. 1999;27:97–132. doi: 1016/S0196-6553(99)70088-X
  11. Lichtenstein IL, Shulman AG, Amid PK, Montllor MM. The tension-free hernioplasty. Am J Surg. 1989;157(2):188-193. doi:1016/0002-9610(89)90526-6.
  12. Miserez, M., Peeters, E., Aufenacker, T. et al.Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 18, 151–163 (2014).   1007/s10029-014-1236-6
  13. McGillicuddy JE. Prospective randomized comparison of the Shouldice and Lichtenstein hernia repair procedures. Arch Surg. 1998;133(9):974-978. doi:1001/archsurg.133.9.974
  14. Danielsson P, Isacson S, Hansen MV. Randomised study of Lichtenstein compared with Shouldice inguinal hernia repair by surgeons in training. Eur J Surg. 1999;165(1):49-53. doi:1080/110241599750007504
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