Evolution of an inguinal hernia surgery practice
M Mokete, J J Earnshaw
Gloucestershire
Royal Hospital, Great Western Road, Gloucester GL1 3NN, UK
Correspondence to: Mr Earnshaw earnshaw{at}rudford.demon.co.uk
Submitted 10 March
2000;
Accepted 11 July 2000
BACKGROUND
Inguinal hernia surgery
has undergone numerous advances in the last few years. This study
analysed the changes in the practice of one surgeon in a district
general hospital over a seven year interval. The effect of changing
from Bassini to Lichtenstein repair in 1994 was evaluated.
METHODSThe study involved two
parts: first a search of a computerised database of inguinal hernia
procedures, and second, postal audits of men who had an inguinal hernia
repair in 1993 and 1994 with outpatient follow up for those with a
possible recurrence.
RESULTSA total of 1037 hernias were repaired over the seven years. There was an increase in
the proportion of day cases from 18% to 70% and the number of
operations performed under local anaesthetic rose from 1% to 45%. The
postal audits had response rates of 79% (1993) and 66% (1994). Some
5/98 (5%) recurrent hernias were identified from the 1993 (Bassini)
patients compared with 1/67 (1.5%) from the 1994 (Lichtenstein) cohort.
CONCLUSIONLichtenstein hernia
repair can be performed safely as a day case using local anaesthetic in
the majority of patients and appears to have a lower recurrence rate
than Bassini repair.
Keywords: inguinal hernia; postoperative complications
© 2001 by The Fellowship of Postgraduate Medicine
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