Early and late outcomes of TEP and Lichtenstein repair for recurrent inguinal hernia repair in men: a comparative study

Authors

  • Mohammed Nazeeh Shaker Nassar Department of Surgery, Menoufia Faculty of Medicine, Menoufia University Hospitals, Menoufia, Egypt
  • Abou Ashour H. S. Department of Surgery, Menoufia Faculty of Medicine, Menoufia University Hospitals, Menoufia, Egypt
  • Mohamed Sabry Amar Department of Surgery, Menoufia Faculty of Medicine, Menoufia University Hospitals, Menoufia, Egypt

DOI:

https://doi.org/10.18203/2349-2902.isj20200277

Keywords:

Laparoscopy, Lichtenstein repair, Recurrent hernia

Abstract

Background: Repair operation for recurrent inguinal hernia is a more exigent than the primary inguinal hernia. Open hernia repair associated with lower recurrence and fewer complications while the Laparoscopic repair associated with less pain postoperatively, early recovery time with subsequent earlier return to activity and better results regarding the wound.

Methods: From November 2015 to March 2019, a total of 86 patients were randomized. 42 patients were recruited to total extra-peritoneal repair (TEP) group and 44 patients for Lichtenstein group. Overall, 86 were operated in general surgery department, Menoufia University hospitals.

Results: The mean age of patients was 41.3±14.4, range from (25-55 years). One conversion occurred in the TEP group to Lichtenstein. Operative time was significantly low in TEP group (82.7 min) compared to Lichtenstein group (108 min). Hospital stay was significantly less in TEP group (1 day) compared to Lichtenstein group (1.8 days). Patients undergoing Lichtenstein repair have significant earlier oral intake than TEP group (3.7 vs. 6.6 hours). 12 cases developed seroma in Lichtenstein group with significant p value (0.001). This study showed less immediate and early VAS score in TEP group (2.3) versus high VAS score in Lichtenstein group (5.9) with highly significant p value (0.0001).

Conclusions: TEP offer excellent results than LR for treatment of unilateral or bilateral recurrent inguinal hernia with lower morbidity and less incidence of post-operative pain with subsequent earlier return to normal activities.

Author Biographies

Mohammed Nazeeh Shaker Nassar, Department of Surgery, Menoufia Faculty of Medicine, Menoufia University Hospitals, Menoufia, Egypt

LECTURER AND CONSULTANT OF GENERAL SURGERY,

Abou Ashour H. S., Department of Surgery, Menoufia Faculty of Medicine, Menoufia University Hospitals, Menoufia, Egypt

associate professor AND CONSULTANT OF GENERAL SURGERY,

Mohamed Sabry Amar, Department of Surgery, Menoufia Faculty of Medicine, Menoufia University Hospitals, Menoufia, Egypt

associate professor AND CONSULTANT OF GENERAL SURGERY,

References

Amid PK. Lichtenstein tension-free hernioplasty: its inception, evolution, and principles. Hernia. 2004;8(1):1-7.

Kurzer M, Belsham PA, Kark AE. The lichtenstein repair. Surg Clin North Am. 1998;78(6):1025-46.

Rutkow IM. Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am. 2003;83(5):1045-51.

Tantia O, Jain M, Khanna S, Sen B. Laparoscopic repair of recurrent groin hernia: results of a prospective study. Surg Endos. 2009;23(4):734.

Haapaniemi S, Gunnarsson U, Nordin P, Nilsson E. Reoperation after recurrent groin hernia repair. Annal Surg. 2001;234(1):122.

Pisanu A, Podda M, Saba A, Porceddu G, Uccheddu A. Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair. Hernia. 2015;19(3):355-66.

Elwan AM, Abomera AM, Makarem MA, Alhamed A, Mohammedain H. Laparoscopic transabdominal preperitoneal repair versus open preperitoneal mesh repair for inguinal hernia. J Arab Society Med Res. 2013;8:38-42.

Burcharth J, Andresen K, Pommergaard HC, Bisgaard T, Rosenberg J. Recurrence patterns of direct and indirect inguinal hernias in a nationwide population in Denmark. Surgery. 2014;155(1):173-7.

Liem MS, van Duyn EB, van der Graaf Y, van Vroonhoven TJ, Coala Trial Group. Recurrences after conventional anterior and laparoscopic inguinal hernia repair: a randomized comparison. Annal Surg. 2003;237(1):136.

Krishna A, Bansal VK, Misra MC, Prajapati O, Kumar S. Totally Extraperitoneal Repair in Inguinal Hernia: More Than a Decade’s Experience at a Tertiary Care Hospital. Surg Laparos, Endos Percutan Techn. 2019;29(4):247-51.

Gass M, Scheiwiller A, Sykora M, Metzger J. TAPP or TEP for recurrent inguinal hernia? Population-based analysis of prospective data on 1309 patients undergoing endoscopic repair for recurrent inguinal hernia. World J Surg. 2016;40(10):2348-52.

Lau H, Patil NG, Yuen WK. Day-case endoscopic totally extraperitoneal inguinal hernioplasty versus open Lichtenstein hernioplasty for unilateral primary inguinal hernia in males. Surg Endosc Other Int Tech. 2006;20(1):76-81.

Mazin JB. Causes of postoperative pain following inguinal hernia repair: what the literature shows. Available at: https://www. Practical pain management.com/causes-postoperative-pain-following-inguinal-hernia-repair-what-literature-shows. Accessed 5 March 2019.

Miserez M, Peeters E, Aufenacker T, Bouillot JL, Campanelli G, Conze J, et al. Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia. 2014;18(2):151-63.

O'Reilly EA, Burke JP, O'Connell PR. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia. Annal Surg. 2012;255(5):846-53.

Han SR, Kim HJ, Kim NH, Shin S, Yoo RN, Kim G, et al. Inguinal hernia surgery in Korea: nationwide data from 2007–2015. Annal Surg Treat Res. 2019;97(1):41-7.

Eklund A, Carlsson P, Rosenblad A, Montgomery A, Bergkvist L, Rudberg C. Long‐term cost‐minimization analysis comparing laparoscopic with open (Lichtenstein) inguinal hernia repair. Bri J Surg. 2010;97(5):765-71.

Downloads

Published

2020-01-27

Issue

Section

Original Research Articles