Cyanoacrylate glue mesh fixation versus suture mesh fixation in Lichtenstein inguinal hernia repair

Background Lichtenstein hernioplasty is becoming more popular in repairing inguinal hernia as it has a low recurrence rate, simplicity to learn, teach, and low costs to the hospital. Cyanoacrylate adhesives have developed over time, mainly through the lengthening of their chemical chains, making them more biocompatible, leading to minimize the toxicity and adverse effects in the host tissue, so it is an optimal choice for the atraumatic mesh fixation. The aim of our study is clarifying the efficacy of the cyanoacrylate glue versus nonabsorbable sutures for mesh fixation in Lichtenstein hernia repair methods with special regard to postoperative groin pain, operative duration, and any other postoperative complications during the follow-up. Patients and methods One hundred and sixty patients with primary inguinal hernia managed by the Lichtenstein hernioplasty were randomized into two groups to receive either glue (Histoacryl) or nonabsorbable polypropylene sutures for polypropylene mesh fixation. The chronic groin pain, recurrence, and other complications were analyzed postoperatively. The statistical analysis was carried out using the Statistical Package for the Social Science. Results We reached 160 patients to the present study. There was a significant difference regarding the groin pain during the first month postoperatively (acute postoperative pain) that is reduced in the glue fixation group (3.8 vs. 25%) (P<0.001). There was no significant differences in the chronic inguinal pain between the study groups that is reduced in the glue fixation group (7.5 vs. 15%) (P=0.133). The operative time was significantly longer in the suture than in the glue (median, 41 min; range, 33-44 min vs. median, 31 min; range, 30-38 min). Conclusion Compared with suture fixation of a mesh, the using of cyanoacrylate glue fixation is a safe and good alternative for Lichtenstein hernia repair with less postoperative pain, a shorter operating time, and a lower rate of recurrences.