Controlled multicenter trial of laparoscopic transabdominal preperitoneal hernioplasty vs Shouldice herniorrhaphy. Early results.
BACKGROUND
In February 1993 a prospective randomized multicenter trial was initiated to compare laparoscopic transabdominal preperitoneal hernioplasty to Shouldice herniorrhaphy as performed by surgeons of nonspecialized clinics.


METHODS
Until January 1994, 87 patients with 108 hernias took part in the trial (43 Shouldice and 44 laparoscopic repairs).


RESULTS
The laparoscopic procedure took significantly longer than did the open operation but caused less pain as measured by pain analogue score and consumption of paracetamol and narcotics. The postoperative complication rate was 26% in the open and 16% in the laparoscopic group. The patients in the laparoscopic group were discharged earlier and their convalescence was shorter than after open hernia repair. There has been one early recurrence in the laparoscopic and two in the open group to date with a mean follow-up of 201 days.


CONCLUSIONS
Laparoscopic hernia repair causes less pain than the conventional operation and enables the patient to return to full work and usual activities earlier. The recurrence rate will not be known for 5 years.
Tschudi
J
J
Department of Surgery, Aarberg Hospital, CH-3270 Aarberg, Switzerland.
Wagner
M
M
Klaiber
C
C
Brugger
J
J
Frei
E
E
Krähenbühl
L
L
Inderbitzi
R
R
Hüsler
J
J
Hsu Schmitz
S
S
D000005:Abdomen; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D011183:Postoperative Complications; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome