Patients and methods
Results
Unadjusted analyses
Operation | ||||
---|---|---|---|---|
Lichtenstein | TEP |
p
| ||
Age (years) | Mean ± STD | 63.2 ± 15.4 | 55.3 ± 15.6 | <0.001 |
BMI (kg/m2) | Mean ± STD | 25.8 ± 3.4 | 25.7 ± 3.3 | 0.201 |
TEP | Lichtenstein |
p
| |||
---|---|---|---|---|---|
n
| % |
n
| % | ||
ASA score | |||||
1 | 2294 | 33.57 | 2980 | 28.23 | <0.001 |
II | 3696 | 54.09 | 4944 | 46.84 | |
III/IV | 843 | 12.34 | 2631 | 24.93 | |
Defect size | |||||
I | 1182 | 17.30 | 1344 | 12.73 | <0.001 |
II | 4411 | 64.55 | 5994 | 56.79 | |
III | 1240 | 18.15 | 3217 | 30.48 | |
EHS classification | |||||
Medial | 1250 | 18.29 | 3339 | 31.63 | <0.001 |
Lateral | 4640 | 67.91 | 5292 | 50.14 | |
Combined | 943 | 13.80 | 1924 | 18.23 | |
Risk factors | |||||
Total | |||||
Yes | 1765 | 25.83 | 4136 | 39.19 | <0.001 |
No | 5068 | 74.17 | 6419 | 60.81 | |
COPD | |||||
Yes | 303 | 4.43 | 896 | 8.49 | <0.001 |
No | 6530 | 95.57 | 9659 | 91.51 | |
Diabetes | |||||
Yes | 299 | 4.38 | 893 | 8.46 | <0.001 |
No | 6534 | 96.52 | 9662 | 91.54 | |
Aortic aneurism | |||||
Yes | 21 | 0.31 | 125 | 1.18 | <0.001 |
No | 6812 | 99.69 | 10430 | 98.82 | |
Immunosuppression | |||||
Yes | 29 | 0.42 | 137 | 1.30 | <0.001 |
No | 6804 | 99.58 | 10,418 | 98.70 | |
Corticoids | |||||
Yes | 68 | 1.00 | 148 | 1.40 | 0.020 |
No | 6765 | 99.00 | 10,407 | 98.60 | |
Smoking | |||||
Yes | 789 | 11.55 | 1250 | 11.84 | 0.563 |
No | 6044 | 88.45 | 9305 | 88.16 | |
Coagulopathy | |||||
Yes | 80 | 1.17 | 235 | 2.23 | <0.001 |
No | 6753 | 98.83 | 10,320 | 97.77 | |
Antiplatelet medication | |||||
Yes | 440 | 6.44 | 1410 | 13.36 | <0.001 |
No | 6393 | 93.56 | 9145 | 86.64 | |
Anticoagulation therapy | |||||
Yes | 96 | 1.40 | 503 | 4.77 | <0.001 |
No | 6737 | 98.60 | 10,052 | 95.23 |
TEP | Lichtenstein |
p
| |||
---|---|---|---|---|---|
n
| % |
n
| % | ||
Intraoperative complications
| |||||
Total | |||||
Yes | 80 | 1.17 | 133 | 1.26 | 0.622 |
No | 6753 | 98.83 | 10,422 | 98.74 | |
Bleeding | |||||
Yes | 52 | 0.76 | 43 | 0.41 | 0.003 |
No | 6781 | 99.24 | 10,512 | 99.59 | |
Injuries | |||||
Total | |||||
Yes | 43 | 0.63 | 103 | 0.98 | 0.017 |
No | 6790 | 99.37 | 10,452 | 99.02 | |
Vascular | |||||
Yes | 19 | 0.28 | 15 | 0.14 | 0.054 |
No | 6814 | 99.72 | 10,540 | 99.86 | |
Bowell | |||||
Yes | 4 | 0.06 | 5 | 0.05 | 0.745 |
No | 6829 | 99.94 | 10,550 | 99.95 | |
Bladder | |||||
Yes | 3 | 0.04 | 3 | 0.03 | 0.685 |
No | 6830 | 99.96 | 10,552 | 99.97 | |
Nerve | |||||
Yes | 0 | 0.00 | 65 | 0.62 | <0.001 |
No | 6833 | 100.0 | 10,490 | 99.38 | |
Postoperative complications
| |||||
Total | |||||
Yes | 115 | 1.68 | 447 | 4.23 | <0.001 |
No | 6718 | 98.32 | 10,108 | 95.77 | |
Bleeding | |||||
Yes | 79 | 1.16 | 260 | 2.46 | <0.001 |
No | 6754 | 98.84 | 10,295 | 97.54 | |
Seroma | |||||
Yes | 35 | 0.51 | 156 | 1.48 | <0.001 |
No | 6798 | 99.49 | 10,399 | 98.52 | |
Infection | |||||
Yes | 4 | 0.06 | 27 | 0.26 | 0.003 |
No | 6829 | 99.94 | 10,528 | 99.74 | |
Bowell injury/anastomotic leakage | |||||
Yes | 0 | 0.00 | 2 | 0.02 | 0.523 |
No | 6833 | 100.0 | 10,553 | 99.98 | |
Wound healing disorders | |||||
Yes | 5 | 0.07 | 37 | 0.35 | <0.001 |
No | 6828 | 99.93 | 10,518 | 99.35 | |
Ileus | |||||
Yes | 0 | 0.00 | 2 | 0.02 | 0.523 |
No | 6833 | 100.0 | 10,553 | 99.98 | |
Reoperations
| |||||
Yes | 49 | 0.72 | 138 | 1.31 | <0.001 |
No | 6784 | 99.28 | 10,417 | 98.69 | |
Recurrence on follow-up
| |||||
Yes | 64 | 0.94 | 88 | 0.83 | 0.505 |
No | 6769 | 99.06 | 10,467 | 99.17 | |
Pain at rest on follow-up
| |||||
Yes | 276 | 4.04 | 487 | 4.61 | 0.075 |
No | 6557 | 95.96 | 10,038 | 95.39 | |
Pain on exertion on follow-up
| |||||
Yes | 540 | 7.90 | 974 | 9.23 | 0.002 |
No | 6293 | 92.10 | 9581 | 90.77 | |
Pain requiring treatment
| |||||
Yes | 160 | 2.34 | 242 | 2.29 | 0.836 |
No | 6673 | 97.36 | 10,313 | 97.71 |
Multivariable analysis
Intraoperative complications
Postoperative complications
Parameter |
p value | Category | OR estimate | 95 % CI | |
---|---|---|---|---|---|
Operation | <0.001 | Lichtenstein versus TEP | 2.152 | 1.734 | 2.672 |
Age [10-year OR] | <0.001 | 1.148 | 1.069 | 1.232 | |
ASA score | <0.001 | II versus I | 0.980 | 0.768 | 1.252 |
III/IV versus I | 1.483 | 1.105 | 1.990 | ||
Risk factors | 0.007 | Yes versus no | 1.295 | 1.075 | 1.561 |
BMI [5-point OR] | 0.153 | 0.909 | 0.797 | 1.036 | |
EHS classification | 0.354 | Lateral versus combined | 1.184 | 0.930 | 1.507 |
Medial versus combined | 1.088 | 0.834 | 1.419 | ||
Defect size | 0.427 | II versus | 0.844 | 0.654 | 1.089 |
III versus | 0.873 | 0.656 | 1.163 |
Reoperation rate
Parameter |
p value | Category | OR estimate | 95 % CI | |
---|---|---|---|---|---|
ASA score | <0.001 | II versus I | 0.890 | 0.562 | 1.408 |
III/IV versus I | 2.174 | 1.297 | 3.642 | ||
Age [10-year OR] | 0.002 | 1.219 | 1.073 | 1.386 | |
Risk factors | 0.037 | Yes versus no | 1.409 | 1.021 | 1.945 |
EHS classification | 0.055 | Lateral versus combined | 0.999 | 0.685 | 1.457 |
Medial versus combined | 0.633 | 0.399 | 1.003 | ||
Operation | 0.084 | Lichtenstein versus TEP | 1.356 | 0.960 | 1.913 |
BMI [5-point OR] | 0.089 | 0.819 | 0.651 | 1.031 | |
Defect size | 0.522 | II versus I | 0.778 | 0.505 | 1.198 |
III versus I | 0.812 | 0.500 | 1.319 |
Recurrence
Parameter |
p value | Category | OR estimate | 95 % CI | |
---|---|---|---|---|---|
BMI [5-point OR] | <0.001 | 1.439 | 1.183 | 1.750 | |
EHS classification | 0.013 | Lateral versus combined | 0.821 | 0.515 | 1.306 |
Medial versus combined | 1.417 | 0.881 | 2.281 | ||
Operation | 0.146 | Lichtenstein versus TEP | 0.775 | 0.549 | 1.093 |
ASA score | 0.240 | II versus I | 1.293 | 0.837 | 1.997 |
III/IV versus I | 1.637 | 0.924 | 2.898 | ||
Defect size | 0.349 | II versus I | 0.744 | 0.468 | 1.184 |
III versus I | 0.905 | 0.539 | 1.519 | ||
Age [10-year OR] | 0.749 | 0.980 | 0.864 | 1.111 | |
Risk factors | 0.981 | Yes versus no | 1.004 | 0.700 | 1.442 |
Pain at rest
Parameter |
p value | Category | OR estimate | 95 % CI | |
---|---|---|---|---|---|
Defect size | <0.001 | II versus I | 0.694 | 0.571 | 0.842 |
III versus I | 0.631 | 0.498 | 0.799 | ||
BMI [5-point OR] | <0.001 | 1.206 | 1.088 | 1.336 | |
Operation | 0.011 | Lichtenstein versus TEP | 1.231 | 1.049 | 1.444 |
Age [10-year OR] | 0.043 | 0.945 | 0.894 | 0.998 | |
EHS classification | 0.680 | Lateral versus combined | 1.047 | 0.847 | 1.295 |
Medial versus combined | 1.106 | 0.876 | 1.396 | ||
ASA score | 0.876 | II versus I | 1.034 | 0.860 | 1.244 |
III/IV versus I | 0.989 | 0.759 | 1.288 | ||
Risk factor | 0.982 | Yes versus no | 0.998 | 0.844 | 1.180 |
Pain on exertion
Parameter |
p value | Category | OR estimate | 95 % CI | |
---|---|---|---|---|---|
Operation | <0.001 | Lichtenstein versus TEP | 1.420 | 1.264 | 1.596 |
Age [10-year OR] | <0.001 | 0.831 | 0.799 | 0.864 | |
Defect size | <0.001 | II versus I | 0.763 | 0.662 | 0.879 |
III versus I | 0.598 | 0.501 | 0.714 | ||
BMI [5-point OR] | <0.001 | 1.162 | 1.077 | 1.254 | |
EHS classification | 0.054 | Lateral versus combined | 1.090 | 0.930 | 1.279 |
Medical versus combined | 1.222 | 1.028 | 1.452 | ||
ASA score | 0.112 | II versus I | 1.066 | 0.935 | 1.216 |
III/IV versus I | 0.902 | 0.739 | 1.101 | ||
Risk factors | 0.343 | yes versus no | 1.061 | 0.939 | 1.199 |
Chronic pain requiring treatment
Parameter |
p value | Category | OR estimate | 95 % CI | |
---|---|---|---|---|---|
BMI [5-point OR] | <0.001 | 1.276 | 1.118 | 1.455 | |
Age [10-year OR] | <0.001 | 0.850 | 0.790 | 0.916 | |
Defect size | <0.001 | II versus I | 0.598 | 0.464 | 0.770 |
III versus I | 0.515 | 0.376 | 0.707 | ||
ASA score | 0.017 | II versus I | 1.397 | 1.078 | 1.810 |
III/IV versus I | 1.620 | 1.130 | 2.325 | ||
Risk factors | 0.185 | Yes versus no | 1.162 | 0.930 | 1.452 |
EHS classification | 0.327 | Lateral versus combined | 0.957 | 0.716 | 1.278 |
Medial versus combined | 1.143 | 0.836 | 1.564 | ||
Operation | 0.560 | Lichtenstein versus TEP | 1.066 | 0.860 | 1.321 |