Recurrences after conventional anterior and laparoscopic inguinal hernia repair: a randomized comparison.
OBJECTIVE
To study the long-term recurrence rate and other complications after conventional and laparoscopic inguinal hernia repair.


BACKGROUND
Reliable long-term follow-up of patients with inguinal hernias treated by laparoscopic repair techniques is lacking.


METHODS
The authors performed a randomized, multicenter trial in which 487 patients with inguinal hernia were treated by totally extraperitoneal laparoscopic repair and 507 patients were treated by conventional anterior hernia repair. Patients were followed and examined for recurrence and chronic inguinal pain 2, 3, and 5 years after surgery. Risk factors for recurrence and chronic inguinal pain were assessed.


RESULTS
Patients who underwent conventional repair had a high risk for recurrence compared to patients who underwent laparoscopic repair. Risk factors for recurrence were operative time and type of conventional repair. Predictive independent risk factors for chronic inguinal pain were conventional repair (Bassini repairs and non-bassini repairs), inguinal pain before surgery, and perioperative lesion of the ilioinguinal nerve.


CONCLUSIONS
Patients with inguinal hernia who undergo laparoscopic repair have fewer recurrences and less chronic inguinal pain than those who undergo conventional open repair. The Bassini repair produces unacceptably high recurrence rates.
Liem
Mike S L
MS
Department of Surgery, University Hospital Utrecht, The Netherlands, s.l.liem@wolmail.nl
van Duyn
Eino B
EB
van der Graaf
Yolanda
Y
van Vroonhoven
Theo J M V
TJ
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000503:physiopathology; D011336:Probability; D012008:Recurrence; D012307:Risk Factors; D017678:Sex Distribution; D016896:Treatment Outcome