A randomized clinical trial of mesh fixation with cyanoacrylate glue compared to sutures in inguinal hernia repair

Abstract

BACKGROUND: The method of mesh fixation in Lichtenstein hernia repair may have an impact on the incidence of chronic groin pain (CGP) after surgery. This study aimed to compare fixation of mesh with N-butyl 2-cyanoacrylate and with sutures in open inguinal hernia repair in terms of CGP, postoperative complications, operation time, and hernia recurrence. PATIENTS AND METHODS: Adult patients with unilateral uncomplicated inguinal hernia were randomly assigned to one of two equal groups. Group I underwent mesh fixation with cyanoacrylate glue and Group II underwent mesh fixation with polypropylene sutures. The main outcome measures were pain scores at 1, 6, and 12 months of follow-up, hernia recurrence, postoperative complications, and operation time. RESULTS: Forty patients (39 male) of an average age of 48.2 years were included in the study. Patients in Group I had significantly lower pain scores at 1 week and 6 and 12 months after surgery than Group II. The operation time in Group I was significantly shorter than Group II (51.7 vs. 58.7 min, P = 0.007). No recurrence of hernia was recorded in either group at 12 months. Four patients in Group I experienced complications as compared to two patients in Group II with no significant difference (P = 0.66). CONCLUSIONS: Fixation of mesh in Lichtenstein repair with cyanoacrylate glue conferred significantly lower pain scores in the early postoperative period and at 6 and 12 months of follow-up than the classical suture fixation. No difference in the hernia recurrence and postoperative complication rates between cyanoacrylate and suture mesh fixation groups was observed.

Keywords

• cyanoacrylate
• fixation
• inguinal hernia
• lichtenstein
• mesh
• suture