Randomized controlled trial of laparoscopic transabdominal preperitoneal hernioplasty vs Shouldice repair.
BACKGROUND
There is a scarcity of data on long-term results after laparoscopic hernia repair. Herein we report on the outcome of a group of patients who were followed up for 5 years in a multicenter study on hernia repair.


METHODS
A total of 100 patients with 127 hernias were randomized to undergo either transabdominal preperitoneal (TAPP) or Shouldice hernia repair. Follow-up was by clinical examination and standardized questionnaire.


RESULTS
Of the 100 patients who underwent surgery, 84 were available for follow-up at 5 years. The TAPP procedure was less painful than the Shouldice repair, with fewer patients receiving narcotic analgesics. The median time to return to 100% activity was shorter in the laparoscopic group (21 days) than in the Shouldice group (40 days). Up to 60 months after the operation, the complication rate was lower in laparoscopically repaired hernias (19/66) than in the open group (25/61). There were two recurrences (3.9%) in the TAPP group and five in the Shouldice group (10.2%).


CONCLUSIONS
The TAPP hernia repair yields comparable or better results than Shouldice herniorrhaphy in terms of postoperative pain, recovery, and recurrence rate.
Tschudi
J F
JF
Department of Surgery, Aarberg Hospital, Spital Aarberg, Lynnstrasse 31, 3270 Aarlberg, Switzerland. drjtschudi@bluemail.ch
Wagner
M
M
Klaiber
C
C
Brugger
J J
JJ
Frei
E
E
Krähenbühl
L
L
Inderbitzi
R
R
Boinski
J
J
Hsu Schmitz
S F
SF
Hüsler
J
J
D000368:Aged; D016001:Confidence Intervals; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control; D017060:Patient Satisfaction; D012008:Recurrence; D012086:Reoperation; D016896:Treatment Outcome