THE COMPARISON OF ANTERIOR AND PREPERITONEAL MESH REPAIR IN HIGH RISK INGUINAL HERNIAS

Abstract

In recent years the synthetic mesh prothesis are commonly used in the treatment of inguinal hernia. There is still a debate about anterior and posterior application of the prothesis. Between 1997-2000, 116 patients with inguinal hernias were prospectively evaluated. 57 patients were treated by means of preperitoneal approach in first group, and 59 patients were treated via anterior approach of mesh placement in second group. Groups were compared with Fisher's exact X2 test in respect of the localization, bilaterality and type of hernia, smoking habits of the patients, previous opererations, type of anesthesia, drainage, wound infection and recurrence. Student's t test was used to evaluate age, weight, duration of operation and analgezia, volume of drainage, cost effect, hospital stay and follow up period of the groups. There was statistically no difference between the groups for hospital stay and volume of the drainage (p>0.05). On the other hand there was a meaningful difference between the groups regarding the duration of the operation, hospitalization and cost effect (p<0.001). There was no difference regarding the recurrences encountered in 3 patients in the 1st group and 2 patients in the second group treated by anterior mesh placement. There was also no superiority one over the other group for recurrence rates. Anterior approach was found to be superior to preperitoneal approach regarding the duration of hospital stay, drainage, analgezia and cost effectivity.