Surgical treatment of inguinal hernia in north african patients, experience of marrakesh morocco

Objective: To compare the Lichtenstein hernioplasty with a laparoscopic technique totally extra peritoneal (TEP) and transabdominal preperitoneal (TAPP) in treatment of inguinal hernias.
Summary Background Data: Only a few studies have compared an open and laparoscopic approach in treatment of inguinal hernia in Africa.
Methods: 670 patients undergoing surgery for inguinal hernia were retrospectively randomized into having either open or laparoscopic mesh repair. Pre, peri and postoperative factors were recorded in addition to 3 months to 4years follow-up data at the surgery control department. The patients were interviewed for recurrent symptoms. The primary end-points chosen were postoperative and chronic pain, resumption of professional activity and hernia recurrence.
Results:  the middle age was 52.2 years, SEX ratio: 14.56. Preoperative factors were the same for the 2 groups such as (practicing tasks load, chronic cough… etc). Recurrence rates were 34 (5.07%) in the Lichtenstein group and 06(0.89 %) in the laparoscopic group, statistically not significant. postoperative pain was more prevalent in the Lichtenstein group (33 cases) compared with the laparoscopic group (03cases). Postoperatively, the Lichtenstein group needed more pain medication. Resumption of professional activity was estimated to 20 days for the two groups.
Conclusions: The laparoscopic techniques in the treatment of inguinal hernia were proven superior to the open mesh repair in several clinical aspects such as pain, recurrent hernia and resumption of professional activity.