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Erschienen in: Surgical Endoscopy 7/2011

01.07.2011

A comparison of outcomes between open and laparoscopic surgical repair of recurrent inguinal hernias

verfasst von: Nilay R. Shah, Dean J. Mikami, Charles Cook, Andrei Manilchuk, Clayton Hodges, Vanchad R. Memark, Eric T. Volckmann, Clinton R. Hall, Steven Steinberg, Bradley Needleman, Jeffrey W. Hazey, W. Scott Melvin, Vimal K. Narula

Erschienen in: Surgical Endoscopy | Ausgabe 7/2011

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Abstract

Background

Inguinal hernia recurrence after surgical repair is a major concern. The authors report their experience with open and laparoscopic repair of recurrent inguinal hernias.

Methods

After institutional review board approval, a retrospective review was performed with the charts of 197 patients who had undergone surgical repair of recurrent inguinal hernias from January 2000 through August 2009, and the data for 172 patients who met the inclusion criteria were analyzed. Surgical variables and clinical outcomes were compared using Student’s t test, the Mann–Whitney U test, chi-square, and Fisher’s exact test as appropriate.

Results

The review showed that 172 patients had undergone either open mesh repair (n = 61) or laparoscopic mesh repair (n = 111) for recurrent inguinal hernias. Postoperative complications were experienced by 8 patients in the open group and 17 patients in laparoscopic group (p = 0.70). Five patients (8.2%) in the open group and four patients (3.6%) in the laparoscopic group had re-recurrent inguinal hernias (p = 0.28). Four patients in the open group (9.5%) and no patients in the laparoscopic group had recurrence during long-term follow-up evaluation (p = 0.046). In the laparoscopic group, 76 patients (68.5%) underwent total extraperitoneal (TEP) repair, and 35 patients (31.5%) had transabdominal preperitoneal (TAPP) repair. Postoperative complications were experienced by 13 patients in the TEP group and 4 patients in the TAPP group (p = 0.44). Two patients (2.6%) in the TEP group and two patients (5.7%) in the TAPP group had re-recurrent inguinal hernias (p = 0.59).

Conclusions

This retrospective review showed no statistical difference in the re-recurrence rate between the two techniques during short-term follow-up evaluation. However, the laparoscopic technique had a significantly lower re-recurrence rate than the open technique during long-term follow-up evaluation. Both procedures were comparable in terms of intra- and postoperative complications. Among laparoscopic techniques, TEP and TAPP repair are acceptable methods for the repair of recurrent inguinal hernia. A multicenter prospective randomized control trial is needed to confirm the findings of this study.
Literatur
1.
Zurück zum Zitat Everhart JE, Ruhl CE (2009) Burden of digestive diseases in the United States part I: overall and upper gastrointestinal diseases. Gastroenterology 136:376–386PubMedCrossRef Everhart JE, Ruhl CE (2009) Burden of digestive diseases in the United States part I: overall and upper gastrointestinal diseases. Gastroenterology 136:376–386PubMedCrossRef
2.
Zurück zum Zitat Everhart JE, Ruhl CE (2009) Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterology 136:741–754PubMedCrossRef Everhart JE, Ruhl CE (2009) Burden of digestive diseases in the United States part II: lower gastrointestinal diseases. Gastroenterology 136:741–754PubMedCrossRef
3.
Zurück zum Zitat Schaap HM, van de Pavoordt HD, Bast TJ (1992) The preperitoneal approach in the repair of recurrent inguinal hernias. Surg Gynecol Obstet 174:460–464PubMed Schaap HM, van de Pavoordt HD, Bast TJ (1992) The preperitoneal approach in the repair of recurrent inguinal hernias. Surg Gynecol Obstet 174:460–464PubMed
4.
Zurück zum Zitat Bittner R, Sauerland S, Schmedt CG (2005) Comparison of endoscopic techniques vs Shouldice and other open nonmesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc 19:605–615PubMedCrossRef Bittner R, Sauerland S, Schmedt CG (2005) Comparison of endoscopic techniques vs Shouldice and other open nonmesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc 19:605–615PubMedCrossRef
5.
Zurück zum Zitat Aufenacker TJ, de Lange DH, Burg MD, Kuiken BW, Hensen EF, Schoots IG, Gouma DJ, Simons MP (2005) Hernia surgery changes in the Amsterdam region 1994–2001: decrease in operations for recurrent hernia. Hernia 9:46–50PubMedCrossRef Aufenacker TJ, de Lange DH, Burg MD, Kuiken BW, Hensen EF, Schoots IG, Gouma DJ, Simons MP (2005) Hernia surgery changes in the Amsterdam region 1994–2001: decrease in operations for recurrent hernia. Hernia 9:46–50PubMedCrossRef
6.
Zurück zum Zitat Bay-Nielsen M, Kehlet H, Strand L, Malmstrom J, Andersen FH, Wara P, Juul P, Callesen T, Danish Hernia Database C (2001) Quality assessment of 26, 304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358:1124–1128PubMedCrossRef Bay-Nielsen M, Kehlet H, Strand L, Malmstrom J, Andersen FH, Wara P, Juul P, Callesen T, Danish Hernia Database C (2001) Quality assessment of 26, 304 herniorrhaphies in Denmark: a prospective nationwide study. Lancet 358:1124–1128PubMedCrossRef
7.
Zurück zum Zitat Bisgaard T, Bay-Nielsen M, Kehlet H (2008) Re-recurrence after operation for recurrent inguinal hernia: a nationwide 8-year follow-up study on the role of type of repair. Ann Surg 247:707–711PubMedCrossRef Bisgaard T, Bay-Nielsen M, Kehlet H (2008) Re-recurrence after operation for recurrent inguinal hernia: a nationwide 8-year follow-up study on the role of type of repair. Ann Surg 247:707–711PubMedCrossRef
8.
Zurück zum Zitat Haapaniemi S, Gunnarsson U, Nordin P, Nilsson E (2001) Reoperation after recurrent groin hernia repair. Ann Surg 234:122–126PubMedCrossRef Haapaniemi S, Gunnarsson U, Nordin P, Nilsson E (2001) Reoperation after recurrent groin hernia repair. Ann Surg 234:122–126PubMedCrossRef
9.
Zurück zum Zitat Junge K, Rosch R, Klinge U, Schwab R, Peiper C, Binnebosel M, Schenten F, Schumpelick V (2006) Risk factors related to recurrence in inguinal hernia repair: a retrospective analysis. Hernia 10:309–315PubMedCrossRef Junge K, Rosch R, Klinge U, Schwab R, Peiper C, Binnebosel M, Schenten F, Schumpelick V (2006) Risk factors related to recurrence in inguinal hernia repair: a retrospective analysis. Hernia 10:309–315PubMedCrossRef
10.
Zurück zum Zitat Grant AM (2002) Open mesh versus nonmesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data (corrected). Hernia 6:130–136PubMedCrossRef Grant AM (2002) Open mesh versus nonmesh repair of groin hernia: meta-analysis of randomised trials based on individual patient data (corrected). Hernia 6:130–136PubMedCrossRef
11.
Zurück zum Zitat Kald A, Nilsson E, Anderberg B, Bragmark M, Engstrom P, Gunnarsson U, Haapaniemi S, Lindhagen J, Nilsson P, Sandblom G, Stubberod A (1998) Reoperation as surrogate end point in hernia surgery: a three year follow-up of 1, 565 herniorrhaphies. Eur J Surg 164:45–50PubMedCrossRef Kald A, Nilsson E, Anderberg B, Bragmark M, Engstrom P, Gunnarsson U, Haapaniemi S, Lindhagen J, Nilsson P, Sandblom G, Stubberod A (1998) Reoperation as surrogate end point in hernia surgery: a three year follow-up of 1, 565 herniorrhaphies. Eur J Surg 164:45–50PubMedCrossRef
12.
Zurück zum Zitat Jansen PL, Klinge U, Jansen M, Junge K (2009) Risk factors for early recurrence after inguinal hernia repair. BMC Surg 9:9–18CrossRef Jansen PL, Klinge U, Jansen M, Junge K (2009) Risk factors for early recurrence after inguinal hernia repair. BMC Surg 9:9–18CrossRef
13.
Zurück zum Zitat Richards SK, Earnshaw JJ (2003) Management of primary and recurrent inguinal hernia by surgeons from the South West of England. Ann R Coll Surg Engl 85:402–404PubMedCrossRef Richards SK, Earnshaw JJ (2003) Management of primary and recurrent inguinal hernia by surgeons from the South West of England. Ann R Coll Surg Engl 85:402–404PubMedCrossRef
14.
Zurück zum Zitat Kouhia ST, Huttunen R, Silvasti SO, Heiskanen JT, Ahtola H, Uotila-Nieminen M, Kiviniemi VV, Hakala T (2009) Lichtenstein hernioplasty versus totally extraperitoneal laparoscopic hernioplasty in treatment of recurrent inguinal hernia: a prospective randomized trial. Ann Surg 249:384–387PubMedCrossRef Kouhia ST, Huttunen R, Silvasti SO, Heiskanen JT, Ahtola H, Uotila-Nieminen M, Kiviniemi VV, Hakala T (2009) Lichtenstein hernioplasty versus totally extraperitoneal laparoscopic hernioplasty in treatment of recurrent inguinal hernia: a prospective randomized trial. Ann Surg 249:384–387PubMedCrossRef
15.
Zurück zum Zitat Richards SK, Vipond MN, Earnshaw JJ (2004) Review of the management of recurrent inguinal hernia. Hernia 8:144–148PubMedCrossRef Richards SK, Vipond MN, Earnshaw JJ (2004) Review of the management of recurrent inguinal hernia. Hernia 8:144–148PubMedCrossRef
16.
Zurück zum Zitat Kald A, Smedh K, Anderberg B (1995) Laparoscopic groin hernia repair: results of 200 consecutive herniorraphies. Br J Surg 82:618–620PubMedCrossRef Kald A, Smedh K, Anderberg B (1995) Laparoscopic groin hernia repair: results of 200 consecutive herniorraphies. Br J Surg 82:618–620PubMedCrossRef
17.
Zurück zum Zitat Topal B, Hourlay P (1997) Totally preperitoneal endoscopic inguinal hernia repair. Br J Surg 84:61–63PubMedCrossRef Topal B, Hourlay P (1997) Totally preperitoneal endoscopic inguinal hernia repair. Br J Surg 84:61–63PubMedCrossRef
18.
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
19.
Zurück zum Zitat Gianetta E, Cuneo S, Vitale B, Camerini G, Marini P, Stella M (2000) Anterior tension-free repair of recurrent inguinal hernia under local anesthesia: a 7-year experience in a teaching hospital. Ann Surg 231:132–136PubMedCrossRef Gianetta E, Cuneo S, Vitale B, Camerini G, Marini P, Stella M (2000) Anterior tension-free repair of recurrent inguinal hernia under local anesthesia: a 7-year experience in a teaching hospital. Ann Surg 231:132–136PubMedCrossRef
20.
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
21.
Zurück zum Zitat Liem MS, van Duyn EB, van der Graaf Y, van Vroonhoven TJ, Coala Trial G (2003) Recurrences after conventional anterior and laparoscopic inguinal hernia repair: a randomized comparison. Ann Surg 237:136–141PubMedCrossRef Liem MS, van Duyn EB, van der Graaf Y, van Vroonhoven TJ, Coala Trial G (2003) Recurrences after conventional anterior and laparoscopic inguinal hernia repair: a randomized comparison. Ann Surg 237:136–141PubMedCrossRef
22.
Zurück zum Zitat Dedemadi G, Sgourakis G, Karaliotas C, Christofides T, Kouraklis G (2006) Comparison of laparoscopic and open tension-free repair of recurrent inguinal hernias: a prospective randomized study. Surg Endosc 20:1099–1104PubMedCrossRef Dedemadi G, Sgourakis G, Karaliotas C, Christofides T, Kouraklis G (2006) Comparison of laparoscopic and open tension-free repair of recurrent inguinal hernias: a prospective randomized study. Surg Endosc 20:1099–1104PubMedCrossRef
23.
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 72–74PubMed Geis WP, Crafton WB, Novak MJ, Malago M (1993) Laparoscopic herniorrhaphy: results and technical aspects in 450 consecutive procedures. Surgery 114:765–772 discussion 72–74PubMed
24.
Zurück zum Zitat Johansson B, Hallerback B, Glise H, Anesten B, Smedberg S, Roman J (1999) Laparoscopic mesh versus open preperitoneal mesh versus conventional technique for inguinal hernia repair: a randomized multicenter trial (SCUR Hernia Repair Study). Ann Surg 230:225–231PubMedCrossRef Johansson B, Hallerback B, Glise H, Anesten B, Smedberg S, Roman J (1999) Laparoscopic mesh versus open preperitoneal mesh versus conventional technique for inguinal hernia repair: a randomized multicenter trial (SCUR Hernia Repair Study). Ann Surg 230:225–231PubMedCrossRef
25.
Zurück zum Zitat Barrat C, Surlin V, Bordea A, Champault G (2003) Management of recurrent inguinal hernias: a prospective study of 163 cases. Hernia 7:125–129PubMedCrossRef Barrat C, Surlin V, Bordea A, Champault G (2003) Management of recurrent inguinal hernias: a prospective study of 163 cases. Hernia 7:125–129PubMedCrossRef
26.
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
27.
Zurück zum Zitat Dulucq JL, Wintringer P, Mahajna A (2009) Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3, 100 hernia repairs over 15 years. Surg Endosc 23:482–486PubMedCrossRef Dulucq JL, Wintringer P, Mahajna A (2009) Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3, 100 hernia repairs over 15 years. Surg Endosc 23:482–486PubMedCrossRef
28.
Zurück zum Zitat Heikkinen TJ, Haukipuro K, Koivukangas P, Hulkko A (1998) A prospective randomized outcome and cost comparison of totally extraperitoneal endoscopic hernioplasty versus Lichtenstein hernia operation among employed patients. Surg Laparosc Endosc 8:338–344PubMedCrossRef Heikkinen TJ, Haukipuro K, Koivukangas P, Hulkko A (1998) A prospective randomized outcome and cost comparison of totally extraperitoneal endoscopic hernioplasty versus Lichtenstein hernia operation among employed patients. Surg Laparosc Endosc 8:338–344PubMedCrossRef
29.
Zurück zum Zitat Lal P, Kajla RK, Chander J, Saha R, Ramteke VK (2003) Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair. Surg Endosc 17:850–856PubMedCrossRef Lal P, Kajla RK, Chander J, Saha R, Ramteke VK (2003) Randomized controlled study of laparoscopic total extraperitoneal versus open Lichtenstein inguinal hernia repair. Surg Endosc 17:850–856PubMedCrossRef
30.
Zurück zum Zitat Sayad P, Ferzli G (1999) Laparoscopic preperitoneal repair of recurrent inguinal hernias. J Laparoendosc Adv Surg Tech A 9:127–130PubMedCrossRef Sayad P, Ferzli G (1999) Laparoscopic preperitoneal repair of recurrent inguinal hernias. J Laparoendosc Adv Surg Tech A 9:127–130PubMedCrossRef
31.
Zurück zum Zitat Kumar S, Nixon SJ, MacIntyre IM (1999) Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: one unit’s experience. J R Coll Surg Edinb 44:301–302PubMed Kumar S, Nixon SJ, MacIntyre IM (1999) Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: one unit’s experience. J R Coll Surg Edinb 44:301–302PubMed
32.
Zurück zum Zitat Feliu X, Jaurrieta E, Vinas X, Macarulla E, Abad JM, Fernandez-Sallent E (2004) Recurrent inguinal hernia: a ten-year review. J Laparoendosc Adv Surg Tech A 14:362–367PubMed Feliu X, Jaurrieta E, Vinas X, Macarulla E, Abad JM, Fernandez-Sallent E (2004) Recurrent inguinal hernia: a ten-year review. J Laparoendosc Adv Surg Tech A 14:362–367PubMed
33.
Zurück zum Zitat Eklund A, Rudberg C, Leijonmarck CE, Rasmussen I, Spangen L, Wickbom G, Wingren U, Montgomery A (2007) Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair. Surg Endosc 21:634–640PubMedCrossRef Eklund A, Rudberg C, Leijonmarck CE, Rasmussen I, Spangen L, Wickbom G, Wingren U, Montgomery A (2007) Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair. Surg Endosc 21:634–640PubMedCrossRef
34.
Zurück zum Zitat Scheuerlein H, Schiller A, Schneider C, Scheidbach H, Tamme C, Kockerling F (2003) Totally extraperitoneal repair of recurrent inguinal hernia. Surg Endosc 17:1072–1076PubMedCrossRef Scheuerlein H, Schiller A, Schneider C, Scheidbach H, Tamme C, Kockerling F (2003) Totally extraperitoneal repair of recurrent inguinal hernia. Surg Endosc 17:1072–1076PubMedCrossRef
35.
Zurück zum Zitat Karthikesalingam A, Markar SR, Holt PJ, Praseedom RK (2010) Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia. Br J Surg 97:4–11 Karthikesalingam A, Markar SR, Holt PJ, Praseedom RK (2010) Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh repair of recurrent inguinal hernia. Br J Surg 97:4–11
36.
Zurück zum Zitat Stoppa RE, Rives JL, Warlaumont CR, Palot JP, Verhaeghe PJ, Delattre JF (1984) The use of Dacron in the repair of hernias of the groin. Surg Clin North Am 64:269–285PubMed Stoppa RE, Rives JL, Warlaumont CR, Palot JP, Verhaeghe PJ, Delattre JF (1984) The use of Dacron in the repair of hernias of the groin. Surg Clin North Am 64:269–285PubMed
37.
Zurück zum Zitat Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W, I Veterans Affairs Cooperative Studies Program I (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, I Veterans Affairs Cooperative Studies Program I (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827PubMedCrossRef
38.
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
39.
Zurück zum Zitat Massaron S, Bona S, Fumagalli U, Battafarano F, Elmore U, Rosati R (2007) Analysis of postsurgical pain after inguinal hernia repair: a prospective study of 1, 440 operations. Hernia 11:517–525PubMedCrossRef Massaron S, Bona S, Fumagalli U, Battafarano F, Elmore U, Rosati R (2007) Analysis of postsurgical pain after inguinal hernia repair: a prospective study of 1, 440 operations. Hernia 11:517–525PubMedCrossRef
40.
Zurück zum Zitat Feliu-Pala X, Martin-Gomez M, Morales-Conde S, Fernandez-Sallent E (2001) The impact of the surgeon’s experience on the results of laparoscopic hernia repair. Surg Endosc 15:1467–1470PubMed Feliu-Pala X, Martin-Gomez M, Morales-Conde S, Fernandez-Sallent E (2001) The impact of the surgeon’s experience on the results of laparoscopic hernia repair. Surg Endosc 15:1467–1470PubMed
41.
42.
Zurück zum Zitat Neumayer L, Jonasson O, Fitzgibbons R, Investigators CSP (2006) Laparoscopic hernia in the light of the Veterans Affairs Cooperative Study 456: more rigorous studies are needed. Surg Endosc 20:1144–1145PubMedCrossRef Neumayer L, Jonasson O, Fitzgibbons R, Investigators CSP (2006) Laparoscopic hernia in the light of the Veterans Affairs Cooperative Study 456: more rigorous studies are needed. Surg Endosc 20:1144–1145PubMedCrossRef
Metadaten
Titel
A comparison of outcomes between open and laparoscopic surgical repair of recurrent inguinal hernias
verfasst von
Nilay R. Shah
Dean J. Mikami
Charles Cook
Andrei Manilchuk
Clayton Hodges
Vanchad R. Memark
Eric T. Volckmann
Clinton R. Hall
Steven Steinberg
Bradley Needleman
Jeffrey W. Hazey
W. Scott Melvin
Vimal K. Narula
Publikationsdatum
01.07.2011
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 7/2011
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1564-2

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