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Background: Treatment of inguinal hernia is still a challenge for the surgeon. The multitude of surgical techniques attests of the difficulty of choosing the best procedure. In the surgical B department of the Charles Nicolle Hospital we have chosen the Lichtenstein technique since 2008. The aim of this study was to evaluate the immediate and long-term results of this technique and to identify the predictive factors of recurrence., Methods: This open prospective study included all patients who underwent an elective inguinal hernia repair in the surgical B department of the Charles Nicolle Hospital between June 1st 2008 and December 31st 2009. These patients were regularly followed for at least three years. Hernia's recurrence was the primary study endpoint. Postoperative pain, wound complications, urinary complications were secondary endpoints.  An univariate and multivariate analysis were performed to identify predictive factor of hernia recurrence., Results: 256 men and eight women were involved in this study with a sex ratio to 32. The average age was 54 years, ranging from 18 to 85 years. we identified seven cases of recurrent hernia (2,6%) with a risk of recurrence at five years equal to 4.9%, 95%CI[4,5 - 5,3].Wound complications were present in 90 patients (34%), dominated by serums seen in 12.1% of cases. The scrotal edema was found in 32 patients (12%). Eight patients kept a postoperative pain after three years of follow-up (3%). The presence of coagulation disorders in pre-operative check-up ( OR 32.25, 95% CI [3.33- 333.3], p = 0.003) and the persistence of pain after one year of intervention ( OR 16.12,95% CI [2.68 -100], p = 0.01) were two predictive factors of hernia recurrence., Conclusion: The Lichtenstein technique remains the gold standard technique in the treatment of inguinal hernias by open surgery. It is a safe, simple, reproducible procedure with a low recurrence rate.

Background: The optimal technique to cure strangulated inguinal hernia remains controversial. The use of mesh in cases of strangulated hernia is still debated due to the potential risk of infection., Objective: This systematic review aimed to determine whether or not the mesh repair technique is associated with a higher risk of surgical site infection than non-mesh techniques for strangulated inguinal hernias in adults., Methods: An electronic search of the relevant literature was performed on 15 December 2012 using the following databases: MEDLINE, the Cochrane Library, Scopus, Embase, and the Web of Science. Articles reporting a comparison between the mesh repair technique and a non-mesh technique to treat strangulated inguinal hernias in adults, and published in the English or French language in a peer-reviewed journal, were considered for analysis. The quality of randomized controlled trials (RCTs) was assessed using the Jadad scoring system. To assess the quality of non-randomized trials, we used the Methodological Index for Non-Randomized Studies (MINORS)., Results: A total of 232 papers was found in the initial search; nine were included in the meta-analysis. The wound infection rate in the mesh repair technique group was lower than in the control group, with a trend towards significance (odds ratio [OR] 0.46, 95 % confidence interval [CI] 0.20-1.07; p = 0.07). The hernia recurrence rate was lower in the mesh repair group (OR 0.2, 95 % CI 0.05-0.78; p = 0.02)., Conclusion: The mesh repair technique is a good option for the treatment of strangulated inguinal hernias in adults, giving an acceptable wound infection rate and fewer recurrences than non-mesh repair. Our study does not allow us to recommend the use of mesh in cases of bowel resection. We emphasize that, except the two RCTs, the results are predicated on patient selection bias by careful surgeons. Further RCTs are required to obtain more powerful evidence-based data.