Low Recurrence Rate After Laparoscopic (TEP) and Open(Lichtenstein) Inguinal Hernia RepairA Randomized, Multicenter Trial With 5-Year Follow-Up
2009 (English)In: Annals of Surgery, ISSN 0003-4932, E-ISSN 1528-1140, Vol. 249, no 1, 33-38 p.Article in journal (Refereed) Published
Objectives: To compare a laparoscopic (totally extraperitoneal patch (TEP)) and an open technique (Lichtenstein) for inguinal hernia repair regarding recurrence rate and possible risk factors for recurrence.
Summary Background Data: Laparoscopic hernia repair has been introduced as an alternative to open repair. Short-term follow-up suggests benefits for those patients operated with a laparoscopic approach compared with open techniques; ie, less postoperative pain and a shorter convalescence period. Long-term results, however, are less well known.
Methods: The study was conducted as a multicenter randomized trial with a 5-year follow-up. A total of 1512 men aged 30 to 70 years, with a primary unilateral inguinal hernia, were randomized to either TEP or Lichtenstein repair.
Results: Overall, 665 patients in the TEP group and 705 patients in the Lichtenstein group were evaluable. The cumulative recurrence rate was 3.5% in the TEP group and 1.2% in the Lichtenstein group (P = 0.008). Test for heterogeneity revealed significant differences between individual surgeons. The exclusion of 1 surgeon, who was responsible for 33% (7 of 21) of all recurrences in the TEP group, lowered the cumulative recurrence rate to 2.4% in this group, which was not statistically different from that of the Lichtenstein group.
Conclusions: The recurrence rate for both TEP and Lichtenstein repair was low. A higher cumulative recurrence rate in the TEP group was seen at 5 years. Further analysis revealed that this could be attributable to incorrect surgical technique.
Place, publisher, year, edition, pages
Lippincott Williams & Wilkins , 2009. Vol. 249, no 1, 33-38 p.
Adult, Aged, Follow-Up Studies, Hernia, Inguinal, Humans, Laparoscopy, Middle Aged, Recurrence, Time Factors, methods
Medical and Health Sciences
Research subject Surgery
IdentifiersURN: urn:nbn:se:uu:diva-107556DOI: 10.1097/SLA.0b013e31819255d0ISI: 000262219300007OAI: oai:DiVA.org:uu-107556DiVA: diva2:231697