[Inguinal hernia. Pre-peritoneal laparoscopic surgery vs. the Stoppa procedure. A prospective randomized trial: 100 cases].
In a prospective randomized trial between totally pre peritoneal (TPP) laparoscopic surgery ant Stoppa procedure (open), 100 patients with groin hernia 'Nyhus IIIA, IIIB, IV) were included and followed during 3 years. Both groups were comparable. In the "laparoscopic" group, operating time was significatelly longer (p = 0.01) but hospital stay (3.2 vs 7.3 days) and delay to return to work (17 vs 35 days) were significantely reduced (p = 0.01 =. Post operative comfort (less pain) was better (p = 0.001) after laparoscopy. In this group, morbidity was also reduced (4% vs 20% p = 0.02). The mean follow up was 605 days and 93 per cent of the patients were reviewed at three years. There was 3 (6%) recurrence after TTP, specially in the beginning of the surgeon experience (learning curve) versus for the Stoppa (ns). In case of bilateral hernia, the authors suggest to use a large prosthesis than two little one to prevent recurrences. In these conditions, laparoscopics (TPP) approach of groin hernia treatment will have the same recurrence rate as open (Stoppa) procedure, but a real advantages in the early post operative period.
Champault
G
G
UFR de Médecine Bobigny Bondy Service de Chirurgie Générale et Digestive, Université Paris XIII.
Rizk
N
N
Catheline
J M
JM
Riskalla
H
H
Boutelier
P
P
D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D018579:Patient Selection; D011446:Prospective Studies; D012008:Recurrence; D013526:Surgical Mesh
Hernies de l'aine. Traitement laparoscopique pré-péritonéal versus opération de Stoppa. Etude randomisée: 100 cas.