Content area
Full Text
Hernia (2012) 16:133144DOI 10.1007/s10029-011-0883-0
ORIGINAL ARTICLE
Comparison of non-mesh (Desarda) and mesh (Lichtenstein) methods for inguinal hernia repair among black African patients: a short-term double-blind RCT
W. Manyilirah S. Kijjambu A. Upoki
J. Kiryabwire
Received: 17 April 2011 / Accepted: 18 September 2011 / Published online: 8 October 2011 Springer-Verlag 2011
AbstractPurpose This study compared the short-term outcomes of the non-mesh (Desarda) and mesh (Lichtenstein) methods of hernia repair among Black African patients, with regard to acute postoperative pain, day of return to normal gait, operative time and complications.
Methods A total of 101 participants (51 in the Lichtenstein arm and 50 in the Desarda arm) were enrolled into this single centre double-blind randomised controlled trial. The outcome measures were evaluated at 12 h, 3, 7 and 14 days. The power of the study was set at 80%, CI at 95% and a two-sided P \ 0.05 was considered statistically signicant.
Results There was no signicant difference in the mean pain score (based on Visual Analogue Scale 010) between the study arms [3rd postoperative day (POD): 3.33 1.75 for Lichtenstein and 2.73 1.64 for Desarda, Effect size (CI): 0.59 (-0.0881.272) and the scores on the 7th POD were 1.31 1.19 for Lichtenstein and 1.31 1.34 for Desarda, effect size (CI): 0.00 (-0.5090.509)]. No difference was observed in regard to mean day of resumption of
normal gait [2.44 1.62 for Lichtenstein and 2.06 1.13 for Desarda, effect size (CI): 0.08 (-0.0300.193)]. A signicant difference was recorded in regard to operative time, with the Desarda repair markedly shorter in duration[15.9 3.52 min for Lichtenstein repair and 10.02 2.93 min for Desardas repair, effect size (CI): 5.92(4.627.20), P = 0.0001]. Complication rates were similar in the two study arms.
Conclusions The results of the study showed that the effectiveness of the Desarda technique with respect to inuencing the early clinical outcomes of hernia repair is similar to that of the Lichtenstein method. However, the operator in this study showed that the Desarda repair requires signicantly shorter operative time.
Keywords Inguinal hernia Desarda Lichtenstein
Mesh Non-mesh Short-term Outcome
Introduction
Inguinal hernias are still the most commonly seen surgical condition in the outpatient departments of hospitals in Uganda and in most African countries. In Mulago Hospital, Uganda, emergency hernia operations...