Abstract
Background
Inguinal hernia is one of the most common diseases in the surgical setting. Bilateral inguinal hernia is present in 12% of patients and its treatment has been debated for long, sequential or simultaneous repair especially after tension-free repairs. We carried out this study to compare the Stoppa procedure with bilateral Lichtenstein hernioplasty for the treatment of bilateral inguinal hernia.
Materials and Methods
The study included 40 patients with bilateral inguinal hernias who were allocated randomly to two groups. Group A included 20 patients who were operated by bilateral Lichtenstein hernioplasty. Group B also included 20 patients who were operated by Stoppa repair. Recording of preoperative data (age, sex, BMI, comorbidity, smoking, and type of hernia), operative data (operative time and operative complications) and postoperative data (complications, pain, hospital stay, return to normal daily activities, chronic groin pain, and recurrence) was performed for each patient in the study. Patients were assessed at 7 days, and 1, 6, and 12 months after the procedure at the outpatient clinic.
Results
All patients were men. There was no statistically significant difference between both groups in preoperative data. The Stoppa procedure took a significantly shorter time than bilateral Lichtenstein repair; the mean operative time for Stoppa and bilateral Lichtenstein was 39.0 +/- 5.15 and 62.25 +/- 7.95 min, respectively. Postoperative pain scoring using the visual analogue score at 12 h postoperatively was significantly lower with the use of the Stoppa procedure than bilateral Lichtenstein repair, but there was no statistically significant difference between both groups in postoperative pain scoring at 24 h and 7 days postoperatively. No significant difference was detected between both groups in operative complications, postoperative complications, hospital stay, return to normal daily activities, and chronic groin pain. No recurrence was detected in any of the patients after 1 year of follow-up.
Conclusion
Bilateral inguinal hernias can be repaired simultaneously in the same setting safely and effectively without an increase in morbidity or recurrence rate. The Stoppa procedure can be a good alternative to bilateral Lichtenstein repair for the treatment of bilateral inguinal hernia, with comparable outcome.