Prospective randomized trial of long-term results of inguinal hernia repair using autoadhesive mesh compared to classic Lichtenstein technique with sutures and polypropylene mesh

The use of autoadhesive meshes with hooks that allow fixation without sutures is a therapeutic alternative to decrease recurrence and chronic pain after inguinal hernia repair. The aim of this study was to evaluate if this kind of mesh has any advantage in long term results in comparison with the classic Lichtenstein technique with sutures and polypropylene mesh. We report a prospective and randomized study of patients who have been operated on for inguinal hernia between march of 2009 to march 2010, divided into 2 groups of 45 patients. In AutoAdhesive (AA) group, we included patients operated on with an autoadhesive mesh and in Classic Lichtenstein (CL) group we included cases with an inguinal hernioplasty with sutured polypropylene mesh. We evaluated time of inactivity, complications, recurrences and grade of pain after one year. The mean age was 60 years in AA group and 49 in LC group. There were more men than women and there were no differences in co-morbilities between groups. The mean size of hernia orifice was 3cm in both groups and 60% of the hernias were indirect. After one year, 77 patients were evaluated; 39 in LC group and 38 in AA group. 86,8% and 87,2% of them were asymptomatic. The mean time of recovery of daily activities was 15 days in both groups. There were neither recurrences nor severe chronic pain in the AA group. The mean of grade of pain was 0 (range:0-4) in AA group and 0 (range: 0-5) in LC group. In this group, there was one recurrence and one patient was taking analgesics for intense pain. No mortality nor other long term complications were found. The use of autoadhesive and parcial reabsorbible meshes in inguinal hernia repair has no effect on recovery of daily activities, postoperative pain and long term complications compared with hernioplasty with polypropylene mesh fixed with monofilament suture.