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

Br J Surg. 2017 May;104(6):688-694. doi: 10.1002/bjs.10488. Epub 2017 Feb 20.

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).

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aftercare
  • Aged
  • Aged, 80 and over
  • Double-Blind Method
  • Female
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy / methods*
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Pain Measurement
  • Pain, Postoperative / etiology
  • Postoperative Care / methods
  • Postoperative Complications / etiology
  • Prospective Studies
  • Surgical Mesh*
  • Sutures
  • Tissue Adhesives / therapeutic use
  • Young Adult

Substances

  • Tissue Adhesives

Associated data

  • ClinicalTrials.gov/NCT02632097