Comparison of totally extraperitoneal versus Lichtenstein operation under local or general anesthesia for inguinal hernia: a meta-analysis
- 01.12.2025
- Original Article
Erschienen in:
- Verfasst von
- Haorui Zha
- Han Yan
- Yingnan Hu
- Ruihan Li
- Yicheng Wang
- Junwen Hu
- Dian Yu
- Weihan Zhu
- Xianghou Zheng
- Jingyi Tang
- Wei Zhang
- Erschienen in
- Hernia | Ausgabe 1/2025
Abstract
Purpose
This meta-analysis compared totally extraperitoneal (TEP) laparoscopic repair with open Lichtenstein repair performed under local or general anaesthesia for unilateral inguinal hernia, asking whether the surgical or anaesthetic approach affects postoperative safety, pain and functional recovery.
Methods
PubMed, Embase, Cochrane and Web of Science were searched to 1 April 2025. Eighteen randomized and observational studies comprising 4302 patients met predefined inclusion criteria. Pooled risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI) were calculated using fixed or randomeffects models; heterogeneity, sensitivity analyses and publication bias were assessed..
Results
No significant recurrence difference between TEP and Lichtenstein (RR = 0.85, 95% CI [0.51, 1.40]). TEP significantly reduced early-Stage Pain (RR = 0.62, 95% CI [0.49, 0.79]), wound infection (RR = 0.54, 95% CI [0.32, 0.91]) and accelerated return to normal activities (MD = -4.44, 95% CI [-6.06, -2.85]). Hematoma, seroma and hospital stay were similar. TEP had longer operative time (MD = 8.22 min, 95%CI[1.00,15.44]), but this gap disappeared in post-2013 studies. Subgroup analysis found that the lower infection risk of TEP was only significant when compared with Lichtenstein repair under local anesthesia (RR = 0.28, 95% CI [0.08, 0.96]).Sensitivity analysis confirmed the robustness of the results, and no publication bias was detected.
Conclusion
TEP and Lichtenstein repair are comparably safe and effective for inguinal hernia repair. TEP may reduce postoperative pain and wound infections, whereas Lichtenstein repair with local anesthesia is suitable for high-risk cardiopulmonary patients. Surgical choice depends on patient, anesthesia, and expertise.
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- Titel
- Comparison of totally extraperitoneal versus Lichtenstein operation under local or general anesthesia for inguinal hernia: a meta-analysis
- Verfasst von
-
Haorui Zha
Han Yan
Yingnan Hu
Ruihan Li
Yicheng Wang
Junwen Hu
Dian Yu
Weihan Zhu
Xianghou Zheng
Jingyi Tang
Wei Zhang
- Publikationsdatum
- 01.12.2025
- Verlag
- Springer Paris
- Erschienen in
-
Hernia / Ausgabe 1/2025
Print ISSN: 1265-4906
Elektronische ISSN: 1248-9204 - DOI
- https://doi.org/10.1007/s10029-025-03424-6
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