Swing mesh <b><i>versus</i></b> Modified Kugel mesh for primary inguinal hernia repair. A prospective randomized clinical trial

Zhou, Zhiyuan; Hu, Xingchen; Zhang, Beili; Gu, Yan

doi:10.1590/S0102-865020160120000009

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Acta Cirúrgica Brasileira

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ORIGINAL ARTICLES • Acta Cir. Bras. 31 (12) • Dec 2016 • https://doi.org/10.1590/S0102-865020160120000009 copy

Swing mesh versus Modified Kugel mesh for primary inguinal hernia repair. A prospective randomized clinical trial^¹ 1 Research performed at Department of General Surgery, Shanghai Jiao Tong University, School of Medicine, Shanghai Ninth People's Hospital, Hernia and Abdominal Wall Surgery Center of Shanghai Jiao Tong University.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

PURPOSE

To evaluate the safety and efficacy of a new mesh in the pre-peritoneal repair of inguinal hernia.

METHODS

We randomly divided 120 patients undergoing pre-peritoneal repair into 2 groups between March 2012 and December 2013. The patients were randomized to receive the Swing mesh (n=60; study group) or the Modified Kugel mesh (n=60; control group). The primary end point of this study was to compare postoperative groin pain of the two groups. Complications, recurrence and analgesic use were also recorded.

RESULTS

There were no recurrent cases in either group throughout the study period. There was no significant difference between the groups with respect to postoperative complications. The VAS of early postoperative pain was 1.32±1.69 in study group and 1.52±1.93 in control group, with the difference being not statistically significant (p = 0.547). Concerning chronic pain, no remarkable statistically significant difference was observed between the two groups at 3-month, 6-month, 12- and 18-month follow-up period.

CONCLUSION

Swing mesh can be safely and effectively used in inguinal hernia repair with the same advantage compared to the Modified Kugel mesh.

Key words:
Hernia; Inguinal; Surgical Mesh

Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia https://actacirbras.com.br/ - São Paulo - SP - Brazil
E-mail: actacirbras@gmail.com

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[1] Correspondence: Yan Gu Department of General Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Hernia and Abdominal Wall Surgery Center of Shanghai Jiao Tong University No.639 Zhizaoju Road, Shanghai 200011, PR. China Phone: +86 21 23271699 Fax: +86 21 63136856guyan2000@126.com

	Control group (n=60)	Study group (n=60)	P -value
Age (years), mean ± SD	60.93±12.75	61.46±11.74	0.881
BMI (kg/m2), mean ± SD	22.61±2.37	23.22±1.42	0.529
Operation time (min) , mean ± SD	33.21±6.81	32.13±7.23	0.937
Gender
male	59(98.3)	58(96.7)	0.559
female	1(1.7)	2(3.3)	0.559
Surgical history
yes	11(18.3)	12(20)	0.817
no	49(81.7)	48(80)	0.817
Site of hernia
left	31(51.6)	22(36.6)	0.245
right	27(45.1)	36(60.1)
Combined	2(3.3)	2(3.3)
Type of hernia
direct	17(28.3)	20(33.3)	0.553
indirect	43(71.7)	40(66.7)	0.553
Recurrent
yes	0(0.0)	2(3.3)	0.154
no	60(100.0)	58(96.7)	0.154
Type of anesthesia
general	1(1.7)	2(3.3)	0.559
local	59(98.3)	58(96.7)

	Control group (n=60)	Study group (n=60)	P -value
2-day visit
complications
yes	1(1.7)	1(1.7)	1.000
no	59(98.3)	59(98.3)	1.000
Recurrences
yes	0(0.0)	0(0.0)	1.000
no	60(100.0)	60(100.0)	1.000
Analgesic use
yes	34(56.7)	29(48.3)	0.361
no	26(43.3)	31(51.7)	0.361
Pain feeling (VAS)	1.52±1.93	1.32±1.69	0.547
3-month visit
complications
yes	3(5)	1(1.7)	0.309
no	57(95)	59(98.3)	0.309
Recurrences
yes	0(0.0)	0(0.0)	1.000
no	60(100.0)	60(100.0)	1.000
Analgesic use
yes	0(0.0)	0(0.0)	1.000
no	60(100.0)	60(100.0)	1.000
Pain feeling (VAS)	0.73±1.31	0.68±1.32	0.836
6-month visit
complications
yes	3(5)	1(1.7)	0.309
no	57(95)	59(98.3)	0.309
Recurrences
yes	0(0.0)	0(0.0)	1.000
no	60(100.0)	60(100.0)	1.000
Analgesic use
yes	0(0.0)	0(0.0)	1.000
no	60(100.0)	60(100.0)	1.000
Pain feeling (VAS)	0.45±0.98	0.36±0.88	0.626
12-month visit
complications
yes	3(5)	1(1.7)	0.309
no	57(95)	59(98.3)	0.309
Recurrences
yes	0(0.0)	0(0.0)	1.000
no	60(100.0)	60(100.0)	1.000
Analgesic use
yes	0(0.0)	0(0.0)	1.000
no	60(100.0)	60(100.0)	1.000
Pain feeling (VAS)	0.27±0.84	0.25±0.67	0.895
18-month visit
complications
yes	3(5)	1(1.7)	0.309
no	57(95)	59(98.3)
Recurrences
yes	0(0.0)	0(0.0)	1.000
no	60(100.0)	60(100.0)
Analgesic use
yes	0(0.0)	0(0.0)	1.000
no	60(100.0)	60(100.0)
Pain feeling (VAS)	0.05±0.29	0.03±0.18	0.704