Shouldice herniorrhaphy - Still an effective technique: A retrospective cohort study

Aim Only 4.8% of general surgeons in our country prefer Shouldice herniorrhaphy in primary inguinal hernia repair. In the evaluation of postoperative complications, this technique, which has the closest results to Lichtenstein herniorrhaphy, could be the preferred method in selected cases of primary inguinal hernia repair. It does not only provide an alternative to the surgeon, but it can also be the first choice in cases where mesh repair cannot be applied. In this study, we aimed to evaluate the efficacy of Shouldice herniorrhaphy in patients who got the primary inguinal hernia diagnosis, comparing Lichtenstein herniorrhaphy. Patients and method Our study was done two-centred. We followed 48 patients who were operated with Lichtenstein technique for a diagnosis of primary inguinal hernia at the General Surgery Clinic of Erzincan Mengücek Gazi Training and Research Hospital between February 2011 and February 2014 and 42 patients who were applied Shouldice technique at Bulancak State Hospital General Surgery Department between January 2010 and February 2013. The patients were evaluated in respect of age, gender, hernia area, hernia type and early or late complications. Findings In respect of early complications, urine retention developed in only 2 (4.7%) patients of the Shouldice group. In the Lichtenstein group, complications developed in a total of 3 (6.3%) patients, as superficial infection was observed in 1 patient, seroma in 1 and urinary retention in 1. When we searched late-stage complications of the patients, paraesthesia developed in the inguinal area of 1 (2.3%) patient in the Shouldice group, and neuralgia developed in 2 (4.1%) patients of the Lichtenstein group. No recurrence was determined in any of the patients. Conclusion In the repair of inguinal hernia, surgeons should not be tied to just one method. Shouldice herniorrhaphy is a good technique that could be the first choice when the use of mesh is not possible and could be an alternative to Lichtenstein herniorrhaphy when done appropriately. In surgical training, it should be considered after the Lichtenstein method in primary inguinal hernia repair. © 2016 The Authors.