MOLONEY DARN REPAIR: VERSUS LICHENSTIEN MESH REPAIR COMPARISON OF COST EFFECTIVENESS & COMPLICATIONS

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Posted in Volume 16 - Number 1

IMAMUDDIN BALOCH, SHER MUHAMMAD SHAIKH, YASMEEN BHATTI, GHULAM SHABIR SHAIKH, RAJIB ALI DEENARI

ABSTRACT | Full Text PDF

OBJECTIVES: To share our experience of inguinal hernia repair with Moloney Darn (MDR) and Lichtenstien mesh repair (LMH) with respect to their cost effectiveness and by comparing the frequency of complications.

PLACE AND DURATION OF STUDY: This prospective study was conducted at Surgical Unit Ii Chandka Medical College Hospital, Larkana from March 2007 to Nov 2008 for a period of 21 months. Included patients presented for elective hernia repair.

SUBJECTS AND METHODS: 200 patients suffering from symptomatic inguinal hernia were admitted. 100 patients (group A) operated for Lichtenstien mesh repair and 100 patients (group B) by Moloney Darn repair. We evaluated and compared analgesic requirement, operative time, hospital stay, cost, early postoperative complications, time until return to work, and recurrence. Those presenting with strangulated or obstructed inguinal hernia as well as recurrent hernia were excluded from the study.

RESULTS: Among 200 patients. Majority of the patients were between the age of 40 to 60 years. In both groups analgesic requirement ranges as NSAID 3-4 doses and 3-5 doses with 1-2 and 1-3 doses of sedative analgesic like pentazocine respectively in both groups. So in Group B averagely 1-2 doses of NSAID and 1 dose of sedative analgesia are more required. Conversely, the mean operative time in group A was 53.57 minutes, and 48.69 minutes in group B .Postoperative hospital stay was slightly shorter in group B. Early postoperative complication rates and the time until return to work did not differ significantly between the two groups. During follow-up, recurrences rate is 1(1%) case in each group. The cost of Darn repair (group B) was significantly less than that of mesh repair (group A).

CONCLUSIONS: Both LMH and MDR resulted in less complication rapid recovery and same recurrence rates; however, the advantage of the MDR lies in the fact that it does not require mesh, so it is much more cost effective.