Comparison Of Self Retaining Freedom Proflor Mesh Repair Versus Lichtenstein Mesh Repair For The Reduction Of Postoperative Pain In Inguinal Hernia” A One Year Randomized Control Trial At KLES Dr Prabhakar Kore Hospital And MRC, Belagavi

Abstract

Background and Objectives Lichtenstein hernia repair is commonly recommended in the management of inguinal hernia and currently, pain is considered the most important complication. The present study was aimed to compare self retaining freedom proflor mesh repair versus Lichtenstein mesh repair for the reduction of postoperative pain in inguinal hernia. Methodology The present one year randomized controlled trial was conducted in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgavi from January 2015 to December 2015. A total of 60 patients requiring mesh repair were randomized into two groups of 30 each based on the type of surgery as group A (freedom proflor mesh repair) and group B (lichtenstein repair). Results In the present study all the patients in both the groups were males. The mean age (53.57±14.31 vs 56.47±13.85 years; p=0.4284) and duration of the symptoms (13.07±9.6 months vs 15.10 ± 8.98 months; p=0.401) in group A and group B were comparable. In this study comparing the VAS on all the five follow ups there were significant lower pain scores in group A than group B. The mean pain scores in group A during first (3.53 ± 1.36 vs. 5.47 ± 2.11), second (1.37 ± 1.5 vs. 4.3 ± 1.51), third (0.47 ± 0.57 vs. 2.37 ± 1.47), fourth (0.3 ± 0.47 vs. 1.53 ±1.43) and fifth (0.2±0.41 vs. 1.07±1.28) follow up were significant compared to group B (p<0.0001). In this study, the mean reduction in pain score from first follow up to fifth follow up was significant in group A (3.3 ± 1.24) compared to group B(4.40 ± 2.04) (p=0.029). All the patients in group A were operated on in less than 30 minutes. In group B only 3.33% were operated upon in the same time period. The rest of the patients from group B (96.67%) were operated on within 31-60 minutes with none in group A The operative time was significantly less in group A compared with group B. In all the patients in the group A the operative time is less than 30 minutes (p<0.05). Conclusion and interpretation Based on the findings of the present study it may be concluded that, the freedom proflor hernia repair significantly reduced the post-operative pain as compared to Lichtenstein hernia repair. There is statistically significant reduction in the operative time in freedom proflor mesh repair group, required less pain medication postoperatively and for shorter time compared to Lichtenstein group. In this study there were no recurrences in one year. However further long term studies are required for documenting hernia recurrences.