[Tension-free laparoscopic versus open inguinal hernia repair].
OBJECTIVE
During the last decade laparoscopic techniques have been applied to the treatment of inguinal hernia to combine tension-free technique, esthetic, and functional benefits of mini-invasive surgery. Anyway controversy persists regarding the most effective inguinal hernia repair. The aim of this study is to compare the open technique and the laparoscopic approach concerning: complications, recurrences, recovery time and return to usual activity.


METHODS
A randomized prospective analysis of 121 consecutive inguinal hernia repairs was performed over a 12-month period. Male well-informed patients with primary monolateral inguinal hernia (ASA I-II) were divided into 2 groups and consecutively treated; group A was treated with laparoscopic transabdominal preperitoneal approach (TAPP) (median age 47+/-7 years, 57 patients), group B with open mesh herniorrhaphy (45+/-6 years, 64 patients).


RESULTS
Complication rate was 5.26% for group A (none needed conversion) and 4.68% for group B. All complications were considered minor. No recurrences were observed over a 12-month follow-up in both groups. Post-operative hospital stay and return to activity show statistically significant differences. Median post-hospital stay was 1.7 days for group A while it was longer (2.9 days) for group B. Significant difference was observed in the duration of convalescence too (group A 9.3+/-7.2 days; group B 12.1+/-7. 1 days).


CONCLUSIONS
On the basis of our experience, even if a longer follow-up is needed, the validity of laparoscopic approach to inguinal hernia is confirmed. General anesthesia and higher costs are reasonable compromises for a shorter period of discomfort in patients with a low ASA index and busy job/sport activity.
Onofrio
L
L
Dipartimento di Chirurgia Generale, Policlinico Universitario Mater Domini, Catanzaro, Italy. Luciano.Onofrio@libero.it
Cafaro
D
D
Manzo
F
F
Cristiano
S F
SF
Sgromo
B
B
Ussia
G
G
D000328:Adult; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000191:economics / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000191:economics; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012008:Recurrence; D013526:Surgical Mesh; D013997:Time Factors