Comparison of Shouldice and Lichtenstein repair for treatment of primary inguinal hernia

Purpose : The purpose of this study was to compare the outcome following Lichtenstein open mesh repair or Shouldice repair for the surgical treatment of primary unilateral inguinal hernias. Patients and methods : Patients with primary unilateral inguinal hernia who underwent a Shouldice repair (n : 120) and a Lichtenstein open mesh techniques (n : 121) between 1994 and 1998 were evaluated retrospectively. Operation time, hospital stay, postoperative analgesic consumption and complications, return to work and recurrence after surgery were assessed and compared. Results : The two groups were comparable regarding age, types of hernia and the follow-up interval. There were no significant differences in hospital stay and postoperative complications. The number of recurrences differed significantly between the groups with five in the Shouldice group (4.1%) and one in the Lichtenstein group (0.8%) (p < 0.05). The need of analgesic medication after mesh repair was significantly lower than the Shouldice group (3.9 +/- 1.4 vs. 4.9 +/- 1.6 gr. p < 0.05). The operation time was 36 +/- 14 min. for Lichtenstein repair and 61 +/- 12 min. for Shouldice repair (p < 0.05). The time for return to work was shorter in Lichtenstein group (17 4 days) compared to Shouldice group (25 5 days) (p < 0.05). Conclusion : Shorter operation time, faster return to work, less need to analgesia and lower recurrence rate, shows the superiority of Lichtenstein repair against Shouldice repair in the surgical repair of primary unilateral inguinal hernia.