Zafarullah Khan, Javed Raza Gardezi.
Lichtenstein tension-free Hernioplasty: an audit.
Pak J Surg Jan ;20(1):16-9.

This prospective, observational study was carried out to assess the feasibility of prosthetic repair for groin hernias in terms of infection, recurrence and cost-effectiveness in a government hospital set-up and to disprove the commonly held notion that using a mesh for groin hernia repair in our tertiary care teaching hospitals is expensive and can lead to infection. A total of 174 hernioplasties were carried out in 166 patients for primary inguinal hernia in the Department of Surgery, Jinnah Hospital Lahore, over a period of four years, starting from March 1999 to March 2003. Only males over 25 years of age, without any co-morbid diseases were selected. The patients were operated mostly under spinal anaesthesia, with three doses of a single antibiotic perioperatively. The patients were followed-up physically for four years on an out door basis. Only one (0.6%) recurrence and two (1.2%) superficial infections were noted. There was no deep-seated infection or any graft rejection. Urinary retention occurred in 9 (5.3%) cases, while hydrocele and haematoma occurred in three cases (1.7%). There was no ischaemic orchitis, deep vein thrombosis or a varicocele following mesh repair. There was no effect on fertility in these patients. There was minimal pain with early return to work and, hence, minimum expenses. It is concluded that Lichtenstein Tension-Free Hernioplasty is a safe and effective procedure that can be performed in a government hospital under spinal and local anaensthesia with very low infection and recurrence rates. It has a good patient compliance due to early mobility and early return to work. All these factors make it cost effective as well.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com