Single-blind randomized clinical trial of transinguinal preperitoneal repair using self-expanding mesh patch vs. Lichtenstein repair for adult male patients with primary unilateral inguinal hernia

Purpose The aim of the study was to compare proportions of chronic postoperative inguinal pain (CPIP) and other surgical outcomes between transinguinal preperitoneal repair with modified Kugel patch (MK) and Lichtenstein repair (LR). Methods Two-hundred adult male patients with primary unilateral inguinal hernia were randomized into MK or LR groups. The primary endpoint was CPIP, pain at 6 months after surgery. Secondary outcomes included recurrence rate, incidence of postoperative complications, time until return to activities, inguinal pain and sensory disturbances assessed at 1 week, 1 month, 3, 6, and 12 months after the operation using an 11-point numerical rating scale (NRS). The study was an intention-to-treat analysis. Results In comparison of MK (n = 100) and LR (n = 100) with similar backgrounds, proportions of CPIP were similar (7.2 vs. 11.1%,p = 0.3452). Favorable outcomes for MK were duration of operation (32 vs. 40 min,p < 0.0001), NRS of foreign body sensation at 1 year (0 [0-1] vs. 0 [0-2],p = 0.0067), and NRS of numbness at 1 month (0 [0-1] vs. 0 [0-3],p = 0.0078) after the operation. Conclusions In regard to CPIP, the short-term results of MK and LR were similar.