Early outcome after open versus extraperitoneal endoscopic tension-free hernioplasty: a randomized clinical trial.
BACKGROUND
The use of minimal access surgery for repair of groin hernias is controversial. The aim of this study was to compare endoscopic tension-free hernia repair with open tension-free hernia repair within a randomized clinical trial.


METHODS
One hundred twenty patients were randomized by four surgeons during a 1-year period. Early outcome measures were then analyzed by intention to treat.


RESULTS
Median postoperative pain scores (63 [interquartile range (IQR), 23 to 81] versus 35 [IQR, 17 to 62]; p = 0.004) and analgesia requirements (2.5 [IQR, 2 to 4] doses verus 2.0 [IQR, 1 to 3] doses; p = 0.0008) were significantly less for patients undergoing endoscopic hernia repair. Hospital stay (1 [IQR, 0 to 1] day versus 2 [IQR, 1 to 2] days; p < 0.0001) was also significantly reduced for the endoscopic group. Wound complications occurred significantly more frequently in the open group. No difference in pulmonary function or metabolic response to trauma (interleukin-6, C-reactive protein, glucose, albumin) was observed between the groups.


CONCLUSIONS
This study shows significant short-term advantages for endoscopic tension-free repair over open tension-free repair. However, larger studies with a longer follow-up period are required to establish the relative merits of both procedures in the management of patients with groin hernias.
Wright
D M
DM
West Glasgow Hospitals University NHS Trust, Scotland.
Kennedy
A
A
Baxter
J N
JN
Fullarton
G M
GM
Fife
L M
LM
Sunderland
G T
GT
O'Dwyer
P J
PJ
D000368:Aged; D004724:Endoscopy; D005260:Female; D006119:Groin; D059685:Herniorrhaphy; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007902:Length of Stay; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D011183:Postoperative Complications; D013997:Time Factors; D016896:Treatment Outcome
D015850:Interleukin-6