Lichtenstein or mesh plug repair: Which is superior for inguinal hernias? To answer this question the study authors randomly assigned 595 patients to one of the 2 operative procedures and looked at outcomes after 1 year. Follow-up was complete for 85% of the study group and revealed no significant differences with respect to recurrence rates or immediate postoperative complications. Operations were shorter, and reoperations within the first year were less frequent in the mesh plug group (4 vs 14), but seromas were more frequent (P = .02) than with Lichtenstein repair.
Viewpoint
The important finding in this large randomized trial shows that these 2 widely used procedures give comparable results with respect to recurrence -- the main outcome of concern. However, the follow-up period in the study is only 1 year, so it will be important to determine whether these findings hold up over longer time periods. The study authors promise to provide 5-year follow-up results when available. Younger patients (< 40 years) were excluded from the study, so we cannot generalize the results to all age groups.