Randomized clinical trial of mesh fixation with glue or sutures for Lichtenstein hernia repair

Author:

Hoyuela C1ORCID,Juvany M1,Carvajal F1,Veres A2,Troyano D1,Trias M1,Martrat A1,Ardid J1,Obiols J1,López-Cano M3

Affiliation:

1. Department of General and Digestive Surgery, Hospital Platón, Barcelona, Spain

2. Department of Surgery, Hospital de la Cerdanya, Puigcerdà, Spain

3. Department of General Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain

Abstract

Abstract Background Pain is the most likely reason for delay in resuming normal activities after groin hernia repair. The primary aim of this study was to determine whether the use of glue to fix the mesh instead of sutures reduced acute postoperative pain after inguinal hernia repair. Secondary objectives were to compare postoperative complications, chronic pain and early recurrence rates during 1-year follow-up. Methods Some 370 patients who underwent Lichtenstein hernia repair were randomized to receive either glue (Histoacryl®) or non-absorbable polypropylene sutures for fixation of lightweight polypropylene mesh. Postoperative complications, pain and recurrence were evaluated by an independent blinded observer. Results Postoperative pain at 8 h, 24 h, 7 days and 30 days was less when glue was used instead of sutures for all measures (P < 0·001). The operation was significantly quicker using glue (mean(s.d.) 35·3(8·7) min versus 39·9(11·1) min for sutures; P < 0·001). There were no significant differences between the groups in terms of postoperative complications, chronic pain and early recurrence at 1-year follow-up. Conclusion Atraumatic mesh fixation with glue was quicker and resulted in less acute postoperative pain than sutures for Lichtenstein hernia repair. Registration number: NCT02632097 (http://www.clinicaltrials.gov).

Publisher

Oxford University Press (OUP)

Subject

Surgery

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