ABSTRACT

There is still not a consensus whether open anterior or preperitoneal approach is the best method for the treatment of recurrent inguinal hernia. In this article we present a retrospective study evaluating both methods with the results.

In a six year period, 31 patients were managed by open anterior and 23 patients by open preperitoneal mesh repair. Early and late results of both techniques are compared.

A total of 54 patients were studied; 23 of these have been managed by open preperitoneal mesh repair and 31 of these by an anterior approach according to Lichtenstein procedure. Despite there is no statistically significant difference in the hospital stay, the group of patients with preperitoneal repair have a lower hospital stay. The average operation time was not different between the two methods, but the bilateral hernia repair with posterior preperitoneal technique was shorter than the open anterior repair. The open posterior approach has a significantly lower early morbidity rate. At long term evaluation, with a mean follow-up of 2.2 (6 months- 4 years) years; there were three recurrences (two anterior, one preperitoneal repairs).

As a result we concluded that the posterior preperitoneal mesh repair should be considered for the management of recurrent inguinal hernia for its lower morbidity rates especially in the bilateral recurrences.

Keywords: Recurrent inguinal hernia, anterior herniorraphy, posterior herniorraphy