Mesh plug versus Bassini operation: a randomized prospective study

Summary The advantages of Rutkow's mesh-plug hernioplasty over the Bassini operation have never been proved in a prospective randomized study. Since 1995 through 1998, in such a study, 70 patients were allocated to the Rutkow mesh plug repair group and 70 treated with the Bassini procedure. Both groups were well-balanced with regard to age, sex, ASA score and type and size of hernia (p > 0.05). The duration of the mesh plug procedure was shorter than for the Bassini operation (mean 42.8 min ± 8.5 (30–65) vs mean 59.2 min ± 17.5 (30–120)). Postoperative pain according to the Visual Analog Scale (VAS) in the plug group ranged from 0–6, mean 26 vs 2–9, mean 5.2, in the Bassini group (p < 0.05). Postoperative complication rates did not differ statistically: 7 (9.5%) vs 13 (16.7%) respectively, wound infection: 2 (2.7%) vs 5 (6.4%) (p > 0.05). Length of hospital stay was statistically shorter in mesh repair (mean 4.3 ± 1.8 days (1–13) vs mean 6.2 ± 5.2 days (1–30) (p < 0,05). Return to everyday activities was faster after the mesh plug procedure than after the Bassini operation due to a shorter and less painful postoperative course. Long-term follow up revealed mild intermittent groin discomfort in over 20% of patients in both groups (p > 0.05). The recurrence rate after the mesh plug procedure was lower than after the Bassini operation –7 (9.4%) vs 16 (20.5%) (p < 0.05). There was greater patient satisfaction after mesh hernioplasty (p < 0.05). Physical examination revealed 4 (51.1%) and 3 (18.8%) recurrences respectively in patients unaware of having this complication (p > 0.05). This kind of follow-up examination is obligatory to assess the true recurrence rate. Results after the mesh plug procedure were better than after the Bassini operation. Postoperative complication rates and long-term discomfort did not differ statistically in the two groups.