Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair: a prospective randomized controlled trial.
BACKGROUND
This study was designed to compare an open tension-free technique (Lichtenstein repair) with a laparoscopic totally extraperitoneal hernia repair (TEP).


METHODS
One hundred sixty-eight men aged 30 to 65 years with primary or recurrent inguinal hernia were randomized to TEP or open mesh technique in the manner of Lichtenstein. Follow-up was after 1 and 6 weeks, and 1 year.


RESULTS
Eighty-one patients were randomized to TEP, and 87 to open repair. For 1 patient in each group, the operation was converted to a different type of repair. No difference was seen in overall complications between the 2 groups. However, 1 patient in the TEP group underwent operation for small bowel obstruction after surgery. A higher frequency of postoperative hematomas was seen in the open group (P <.05). Patients in the TEP group consumed less analgesic after surgery (P <.001), returned to work earlier (P <.01), and had a shorter time to full recovery (P <.01). Two recurrences occurred in the TEP group 1 year after surgery.


CONCLUSIONS
The TEP technique was associated with less postoperative pain, a shorter time to full recovery, and an earlier return to work compared with the open tension-free repair. No difference was seen in overall complications. However, 2 recurrences did occur after 1 year in the TEP group.
Andersson
Bodil
B
Department of Surgery, Lund University Hospital, Lund, Sweden.
Hallén
Magnus
M
Leveau
Per
P
Bergenfelz
Anders
A
Westerdahl
Johan
J
D000328:Adult; D000700:Analgesics / Q000008:administration & dosage; D004651:Employment; D006406:Hematoma / Q000453:epidemiology / Q000209:etiology; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013526:Surgical Mesh
D000700:Analgesics