Randomized trial of modified Bassini versus Shouldice inguinal hernia repair

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Abstract
Between 1986 and 1992, 265 men of mean age 51 (range 16–75) years with a primary inguinal hernia were randomized to undergo surgery by staff surgeon or surgical resident and further randomized to receive a modified Bassini operation (transversalis fascia not divided but included in the repair) or Shouldice procedure. The follow‐up rate was 92·1 per cent with a mean follow‐up of 3·3 years. Recurrence developed in 12 of 125 patients with a Bassini procedure and two of 119 after a Shouldice repair (9·6 versus 1·7 per cent, P= 0·006). The recurrence rate was no different for staff surgeons and trainees (5·9 versus 5·6 per cent, P not significant). Multivariate analysis identified the presence of a direct hernia (P=0·003) as the additional main factor for the development of recurrence.