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Erschienen in: Surgical Endoscopy 4/2007

01.04.2007

Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair

verfasst von: A. Eklund, C. Rudberg, C. -E. Leijonmarck, I. Rasmussen, L. Spangen, G. Wickbom, U. Wingren, A. Montgomery

Erschienen in: Surgical Endoscopy | Ausgabe 4/2007

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Abstract

Background

The optimal treatment for recurrent inguinal hernia is of concern due to the high frequency of recurrence.

Methods

This randomized multicenter study compared the short- and long-term results for recurrent inguinal hernia repair by either the laparoscopic transabdominal preperitoneal patch (TAPP) procedure or the Lichtenstein technique.

Results

A total of 147 patients underwent surgery (73 TAPP and 74 Lichtenstein). The operating time was 65 min (range, 23–165 min) for the TAPP group and 64 min (range, 25–135 min) for the Lichtenstein group. Patients who underwent TAPP reported significantly less postoperative pain and shorter sick leave (8 vs 16 days). The recurrence rate 5 years after surgery was 19% for the TAPP group and 18% for the Lichtenstein group.

Conclusion

The short-term advantage for patients who undergo the laparoscopic technique is less postoperative pain and shorter sick leave. In the long term, no differences were observed in the chronic pain or recurrence rate.
Literatur
1.
Zurück zum Zitat Aasvang E, Kehlet H (2005) Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth 95: 69–76PubMedCrossRef Aasvang E, Kehlet H (2005) Chronic postoperative pain: the case of inguinal herniorrhaphy. Br J Anaesth 95: 69–76PubMedCrossRef
2.
Zurück zum Zitat Abrahamson J (1994) Factors and mechanisms leading to recurrence. In: Bendavid R (ed) Prostheses and abdominal wall hernias. RG Landes Company, Austin, TX pp 138–170 Abrahamson J (1994) Factors and mechanisms leading to recurrence. In: Bendavid R (ed) Prostheses and abdominal wall hernias. RG Landes Company, Austin, TX pp 138–170
3.
Zurück zum Zitat Arregui M (1993) Laparoscopic inguinal herniorrhaphy. Surg Clin North Am 73: 513–526PubMed Arregui M (1993) Laparoscopic inguinal herniorrhaphy. Surg Clin North Am 73: 513–526PubMed
4.
Zurück zum Zitat Arvidsson D, Berndsen F H, Larsson L G, Leijonmarck C E, Rimback G, Rudberg C, Smedberg S, Spangen L, Montgomery A (2005) Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus Shouldice repair of primary inguinal hernia. Br J Surg 92: 1085–1091PubMedCrossRef Arvidsson D, Berndsen F H, Larsson L G, Leijonmarck C E, Rimback G, Rudberg C, Smedberg S, Spangen L, Montgomery A (2005) Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus Shouldice repair of primary inguinal hernia. Br J Surg 92: 1085–1091PubMedCrossRef
5.
Zurück zum Zitat Bay-Nielsen M, Perkins FM, Kehlet H (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 233: 1–7PubMedCrossRef Bay-Nielsen M, Perkins FM, Kehlet H (2001) Pain and functional impairment 1 year after inguinal herniorrhaphy: a nationwide questionnaire study. Ann Surg 233: 1–7PubMedCrossRef
6.
Zurück zum Zitat Beets GL, Dirksen CD, Go PM, Geisler FE, Baeten CG, Kootstra G (1999) Open or laparoscopic preperitoneal mesh repair for recurrent inguinal hernia? A randomized controlled trial. Surg Endosc 13: 323–327PubMedCrossRef Beets GL, Dirksen CD, Go PM, Geisler FE, Baeten CG, Kootstra G (1999) Open or laparoscopic preperitoneal mesh repair for recurrent inguinal hernia? A randomized controlled trial. Surg Endosc 13: 323–327PubMedCrossRef
7.
Zurück zum Zitat Bendavid R (1994) Expectations of hernia surgery (inguinal and femoral). In: Paterson-Brown S, Garden J (ed) Principles and practice of surgical laparoscopy. WB Saunders, Philadelphia pp 387–414 Bendavid R (1994) Expectations of hernia surgery (inguinal and femoral). In: Paterson-Brown S, Garden J (ed) Principles and practice of surgical laparoscopy. WB Saunders, Philadelphia pp 387–414
8.
Zurück zum Zitat Berndsen F, Arvidsson D, Enander LK, Leijonmarck CE, Wingren U, Rudberg C, Smedberg S, Wickbom G, Montgomery A. (2002) Postoperative convalescence after inguinal hernia surgery: prospective randomized multicenter study of laparoscopic versus Shouldice inguinal hernia repair in 1,042 patients. Hernia 6: 56–61PubMedCrossRef Berndsen F, Arvidsson D, Enander LK, Leijonmarck CE, Wingren U, Rudberg C, Smedberg S, Wickbom G, Montgomery A. (2002) Postoperative convalescence after inguinal hernia surgery: prospective randomized multicenter study of laparoscopic versus Shouldice inguinal hernia repair in 1,042 patients. Hernia 6: 56–61PubMedCrossRef
9.
Zurück zum Zitat Bittner R, Schmedt CG, Schwarz J, Kraft K, Leibl BJ (2002) Laparoscopic transperitoneal procedure for routine repair of groin hernia. Br J Surg 89: 1062–1066PubMedCrossRef Bittner R, Schmedt CG, Schwarz J, Kraft K, Leibl BJ (2002) Laparoscopic transperitoneal procedure for routine repair of groin hernia. Br J Surg 89: 1062–1066PubMedCrossRef
10.
Zurück zum Zitat Collaboration EH (2000) Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87: 860–867PubMedCrossRef Collaboration EH (2000) Laparoscopic compared with open methods of groin hernia repair: systematic review of randomized controlled trials. Br J Surg 87: 860–867PubMedCrossRef
11.
Zurück zum Zitat Danielsson P, Isacson S, Hansen MV (1999) Randomised study of Lichtenstein compared with Shouldice inguinal hernia repair by surgeons in training. Eur J Surg 165: 49–53PubMed Danielsson P, Isacson S, Hansen MV (1999) Randomised study of Lichtenstein compared with Shouldice inguinal hernia repair by surgeons in training. Eur J Surg 165: 49–53PubMed
12.
Zurück zum Zitat Deans GT, Wilson MS, Royston CM, Brough WA (1995) Recurrent inguinal hernia after laparoscopic repair: possible cause and prevention. Br J Surg 82: 539–541PubMedCrossRef Deans GT, Wilson MS, Royston CM, Brough WA (1995) Recurrent inguinal hernia after laparoscopic repair: possible cause and prevention. Br J Surg 82: 539–541PubMedCrossRef
13.
Zurück zum Zitat Douek M, Smith G, Oshowo A, Stoker DL, Wellwood JM (2003) Prospective randomised controlled trial of laparoscopic versus open inguinal hernia mesh repair: five-year follow up. BMJ 326: 1012–1013PubMedCrossRef Douek M, Smith G, Oshowo A, Stoker DL, Wellwood JM (2003) Prospective randomised controlled trial of laparoscopic versus open inguinal hernia mesh repair: five-year follow up. BMJ 326: 1012–1013PubMedCrossRef
14.
Zurück zum Zitat Edwards CC II, Bailey RW (2000) Laparoscopic hernia repair: the learning curve. Surg Laparosc Endosc Percutan Tech 10: 149–153PubMedCrossRef Edwards CC II, Bailey RW (2000) Laparoscopic hernia repair: the learning curve. Surg Laparosc Endosc Percutan Tech 10: 149–153PubMedCrossRef
15.
Zurück zum Zitat Eklund A, Rudberg C, Smedberg S, Enander LK, Leijonmarck CE, Osterberg J, Montgomery A (2006) Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair. Br J Surg 93: 1060–1068PubMedCrossRef Eklund A, Rudberg C, Smedberg S, Enander LK, Leijonmarck CE, Osterberg J, Montgomery A (2006) Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair. Br J Surg 93: 1060–1068PubMedCrossRef
16.
Zurück zum Zitat Felix EL, Michas C, McKnight RL (1994) Laparoscopic repair of recurrent groin hernias. Surg Laparosc Endosc 4: 200–204PubMed Felix EL, Michas C, McKnight RL (1994) Laparoscopic repair of recurrent groin hernias. Surg Laparosc Endosc 4: 200–204PubMed
17.
Zurück zum Zitat Filipi CJ, Gaston-Johansson F, McBride PJ, Murayama K, Gerhardt J, Cornet DA, Lund RJ, Hirai D, Graham R, Patil K, Fitzgibbons R Jr, Gaines RD (1996) An assessment of pain and return to normal activity: laparoscopic herniorrhaphy vs open tension-free Lichtenstein repair. Surg Endosc 10: 983–986PubMedCrossRef Filipi CJ, Gaston-Johansson F, McBride PJ, Murayama K, Gerhardt J, Cornet DA, Lund RJ, Hirai D, Graham R, Patil K, Fitzgibbons R Jr, Gaines RD (1996) An assessment of pain and return to normal activity: laparoscopic herniorrhaphy vs open tension-free Lichtenstein repair. Surg Endosc 10: 983–986PubMedCrossRef
18.
Zurück zum Zitat Friedman DW, Boyd CD, Norton P, Greco RS, Boyarsky AH, Mackenzie JW, Deak SB (1993) Increases in type III collagen gene expression and protein synthesis in patients with inguinal hernias. Ann Surg 218: 754–760PubMedCrossRef Friedman DW, Boyd CD, Norton P, Greco RS, Boyarsky AH, Mackenzie JW, Deak SB (1993) Increases in type III collagen gene expression and protein synthesis in patients with inguinal hernias. Ann Surg 218: 754–760PubMedCrossRef
19.
Zurück zum Zitat Geis WP, Crafton WB, Novak MJ, Malago M (1993) Laparoscopic herniorrhaphy: results and technical aspects in 450 consecutive procedures. Surgery 114: 765–772, discussion 772–774PubMed Geis WP, Crafton WB, Novak MJ, Malago M (1993) Laparoscopic herniorrhaphy: results and technical aspects in 450 consecutive procedures. Surgery 114: 765–772, discussion 772–774PubMed
20.
Zurück zum Zitat Grant AM, Scott NW, O’Dwyer PJ (2004) Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 91: 1570–1574PubMedCrossRef Grant AM, Scott NW, O’Dwyer PJ (2004) Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 91: 1570–1574PubMedCrossRef
21.
Zurück zum Zitat Haapaniemi S, Nilsson E. (2002) Recurrence and pain three years after groin hernia repair: validation of postal questionnaire and selective physical examination as a method of follow-up. Eur J Surg 168: 22–28PubMedCrossRef Haapaniemi S, Nilsson E. (2002) Recurrence and pain three years after groin hernia repair: validation of postal questionnaire and selective physical examination as a method of follow-up. Eur J Surg 168: 22–28PubMedCrossRef
22.
Zurück zum Zitat Iles JD (1965) Specialisation in elective herniorrhaphy. Lancet 17: 751–755CrossRef Iles JD (1965) Specialisation in elective herniorrhaphy. Lancet 17: 751–755CrossRef
24.
Zurück zum Zitat Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157: 188–193PubMedCrossRef Lichtenstein IL, Shulman AG, Amid PK, Montllor MM (1989) The tension-free hernioplasty. Am J Surg 157: 188–193PubMedCrossRef
25.
Zurück zum Zitat Liem MS, van der Graaf Y, Zwart RC, Geurts I, van Vroonhoven TJ (1997) A randomized comparison of physical performance following laparoscopic and open inguinal hernia repair. The Coala Trial Group. Br J Surg 84: 64–67 Liem MS, van der Graaf Y, Zwart RC, Geurts I, van Vroonhoven TJ (1997) A randomized comparison of physical performance following laparoscopic and open inguinal hernia repair. The Coala Trial Group. Br J Surg 84: 64–67
26.
Zurück zum Zitat McCormack K, Scott NW, Go PM, Ross S, Grant AM (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev CD001785 McCormack K, Scott NW, Go PM, Ross S, Grant AM (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev CD001785
27.
Zurück zum Zitat McKernan JB (1993) Laparoscopic extraperitoneal repair of inguinofemoral herniation. Endosc Surg Allied Technol 1: 198–203PubMed McKernan JB (1993) Laparoscopic extraperitoneal repair of inguinofemoral herniation. Endosc Surg Allied Technol 1: 198–203PubMed
28.
Zurück zum Zitat Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90: 1479–1492PubMedCrossRef Memon MA, Cooper NJ, Memon B, Memon MI, Abrams KR (2003) Meta-analysis of randomized clinical trials comparing open and laparoscopic inguinal hernia repair. Br J Surg 90: 1479–1492PubMedCrossRef
29.
Zurück zum Zitat Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350: 1819–1827PubMedCrossRef Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350: 1819–1827PubMedCrossRef
30.
Zurück zum Zitat Page B, Paterson C, Young D, O’Dwyer PJ (2002) Pain from primary inguinal hernia and the effect of repair on pain. Br J Surg 89: 1315–1318PubMedCrossRef Page B, Paterson C, Young D, O’Dwyer PJ (2002) Pain from primary inguinal hernia and the effect of repair on pain. Br J Surg 89: 1315–1318PubMedCrossRef
31.
Zurück zum Zitat Phillips EH, Rosenthal R, Fallas M, Carroll B, Arregui M, Corbitt J, Fitzgibbons R, Seid A, Schultz L, Toy F, et al. (1995) Reasons for early recurrence following laparoscopic hernioplasty. Surg Endosc 9: 140–144, discussion 144–145PubMed Phillips EH, Rosenthal R, Fallas M, Carroll B, Arregui M, Corbitt J, Fitzgibbons R, Seid A, Schultz L, Toy F, et al. (1995) Reasons for early recurrence following laparoscopic hernioplasty. Surg Endosc 9: 140–144, discussion 144–145PubMed
32.
Zurück zum Zitat Poobalan AS, Bruce J, King PM, Chambers WA, Krukowski ZH, Smith WC (2001) Chronic pain and quality of life following open inguinal hernia repair. Br J Surg 88: 1122–1126PubMedCrossRef Poobalan AS, Bruce J, King PM, Chambers WA, Krukowski ZH, Smith WC (2001) Chronic pain and quality of life following open inguinal hernia repair. Br J Surg 88: 1122–1126PubMedCrossRef
33.
Zurück zum Zitat Sandbichler P, Draxl H, Gstir H, Fuchs H, Furtschegger A, Egender G, Steiner E (1996) Laparoscopic repair of recurrent inguinal hernias. Am J Surg 171: 366–368PubMedCrossRef Sandbichler P, Draxl H, Gstir H, Fuchs H, Furtschegger A, Egender G, Steiner E (1996) Laparoscopic repair of recurrent inguinal hernias. Am J Surg 171: 366–368PubMedCrossRef
34.
Zurück zum Zitat Schmedt CG, Sauerland S, Bittner R (2005) Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc 19: 188–199PubMedCrossRef Schmedt CG, Sauerland S, Bittner R (2005) Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc 19: 188–199PubMedCrossRef
35.
Zurück zum Zitat Schultz C, Baca I, Gotzen V. (2001) Laparoscopic inguinal hernia repair. Surg Endosc 15: 582–584PubMedCrossRef Schultz C, Baca I, Gotzen V. (2001) Laparoscopic inguinal hernia repair. Surg Endosc 15: 582–584PubMedCrossRef
36.
37.
Zurück zum Zitat Stoppa RE (1989) The treatment of complicated groin and incisional hernias. World J Surg 13: 545–554PubMedCrossRef Stoppa RE (1989) The treatment of complicated groin and incisional hernias. World J Surg 13: 545–554PubMedCrossRef
38.
Zurück zum Zitat Vos PM, Simons MP, Luitse JS, van Geldere D, Koelemaij MJ, Obertop H (1998) Follow-up after inguinal hernia repair: questionnaire compared with physical examination: a prospective study in 299 patients. Eur J Surg 164: 533–536PubMedCrossRef Vos PM, Simons MP, Luitse JS, van Geldere D, Koelemaij MJ, Obertop H (1998) Follow-up after inguinal hernia repair: questionnaire compared with physical examination: a prospective study in 299 patients. Eur J Surg 164: 533–536PubMedCrossRef
39.
Zurück zum Zitat Wantz GE (1982) Testicular atrophy as a risk inguinal hernioplasty. Surg Gynecol Obstet 154: 570–571PubMed Wantz GE (1982) Testicular atrophy as a risk inguinal hernioplasty. Surg Gynecol Obstet 154: 570–571PubMed
40.
Zurück zum Zitat Wantz GE (1984) Complications of inguinal hernial repair. Surg Clin North Am 64: 287–298PubMed Wantz GE (1984) Complications of inguinal hernial repair. Surg Clin North Am 64: 287–298PubMed
41.
Zurück zum Zitat Wellwood J, Sculpher MJ, Stoker D, Nicholls GJ, Geddes C, Whitehead A, Singh R, Spiegelhalter D (1998) Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. BMJ 317: 103–110PubMed Wellwood J, Sculpher MJ, Stoker D, Nicholls GJ, Geddes C, Whitehead A, Singh R, Spiegelhalter D (1998) Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. BMJ 317: 103–110PubMed
Metadaten
Titel
Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair
verfasst von
A. Eklund
C. Rudberg
C. -E. Leijonmarck
I. Rasmussen
L. Spangen
G. Wickbom
U. Wingren
A. Montgomery
Publikationsdatum
01.04.2007
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 4/2007
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-006-9163-y

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