الفهرس 
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Abstract
As we mentioned before, incarcerated inguinal hernia is a common surgical emergencies and if not properly managed, serious complications could happen including death. Lichtenstein hernioplasty has been established as the method of choice for the management of uncomplicated inguinal hernias but the use of it in incarceration remains controversial because surgical mesh presumed to increase that risk of infection.
Our study was to evaluate the use of prolene mesh by comparing Lichtenstein tension-free hernioplasty to Bassini herniorraphy in managing acutely incarcerated inguinal hernia. It was concerned primary to compare the incidence of local wound infection between both techniques. It also aimed to compare mean operative time, postoperative hospital stay and other postoperative complications.
It was conducted as a prospective single-blinded randomized clinical trial. It was undertaken in both Suez Canal university hospital and Ismailia General Hospital.
Sixty patients were enrolled in the final analysis. They were randomly assigned into two groups, group I (Lichtenstein group) and group II (Bassini group). Patients with recurrent hernia or Strangulated hernia ended by resection and anastomosis of intestine with or without surgical field contamination were excluded.
Data collection throughout history questionnaire and clinical examinations were at the day of admission, day of discharge and one month after performing the surgery. These data were coded, entered and analyzed using Microsoft Excel software. Statistical Package for Social Science 16.0 (SPSS 16) for Windows was used for data analysis. Values of a p < 0•05 will be considered statistically significant. Medical ethics were considered by informed consent and official approval.
All patients included were males. Mean age of patients were similar in both groups. Most of patients were smoker. Health status evaluation of patients through ASA classification, showed no significant difference in all ASA classes when compared to each other.
Most of patients had inguinal hernia situated in the right side. The mean duration of preexisting hernia was similar in both groups. Most of them had incarcerated hernia for less than one day. Signs and symptoms of hernia in the patients compared in both groups had insignificant difference.
Regarding possible causes of hernia as weak mesenchyme syndrome, the study showed no differences could be found while comparing both groups. Truss usage in hernia patients is an important role in hernia incarceration. Most of patients did not use.
Most of patients had spinal anesthesia and only small proportion had general anesthesia. Indirect type of inguinal hernia was found in most patients in both groups with insignificant difference. Main content of incarcerated inguinal hernia showed nearly equal distribution between part of greater omentum and loops of small intestine with small proportion for part of the sigmoid colon.
Time of surgery showed less mean operative time in Lichtenstein group with significant statistical difference. Mean duration of post-operative stay was also less in Lichtenstein group with no significant difference. But after categorizing the hospitalization period, significant difference was found in Bassini group that most of the patients stayed more than 1 day while nearly half of patients in Lichtenstein group had the same period.
Regarding complications after surgery, there was no significant difference between both groups. Most of patients in both groups had no post-operative complication at all. It was found no difference in post-operative local wound infection between both groups which was the primary objective of the study.
There were only two patients in each group with superficial wound infection that needed only medical treatment after drainage to manage it with no need for any other surgical intervention as removal of the mesh.
Other local complications included seroma, hematoma, genital swelling and chronic inguinal pain. All needed medications for cure in few weeks.
In conclusion, mesh repair is applicable in patients with incarcerated inguinal hernias with low morbidity rate. Significantly higher rates for mean length of hospital stay, mean length of operation and higher rate for postoperative chronic pain were found in incarcerated inguinal hernia patients who received urgent surgical intervention by Bassini repair as one of the conventional methods for herniorraphy.
We believe that Lichtenstein method can be reliably applied in patients with incarcerated inguinal hernias because this method is safe, and the risk of the local infectious complications is low. It does not extend length of hospital stay or time of operation but in fact it lesser it and it definitely decreases recurrence on the long run.