title: Lower incidence of inguinal hernia: minilaparotomy radical retropubic prostatectomy compared with conventional technique. A preliminary report.
abstract: BACKGROUND
  The purpose of the present study was to compare the incidence of inguinal hernias after conventional and minilaparotomy (minilap) radical retropubic prostatectomy (RRP).
  
  
  METHODS
  In this retrospective study, we review our experience with 70 consecutive patients with prostate cancer who underwent prostatectomy from April 1995 through March 2001. Of these, 35 patients had conventional RRP, and 35 patients had minilap RRP.
  
  
  RESULTS
  Conventional RRP and minilap RRP groups were similar in body mass index (mean 24.4 and 23.5), operative time (mean 260 and 241 min), previous lower abdominal operation record (mean 37.1 and 25.7%), and post-prostatectomy anastomotic strictures (mean 11.4 and 14.3%). The volume of the estimated blood loss was significantly less for minilap RRP (mean 1,220 ml) than for conventional RRP (mean 1,666 ml; p = 0.0194). The incidence of postoperative inguinal hernias was 17.1% (6 of 35), 2.9% (1 of 35), and 3.2% (1 of 31) in conventional RRP, minilap RRP, and unoperated groups, respectively. The incidence of inguinal hernias after minilap RRP was significantly lower than after conventional RRP (p = 0.0464). Seven patients with postoperative inguinal hernias had a high incidence of postoperative strictures (42.9%), while 63 patients without hernia had a low incidence (9.5%). There was a significant difference in developing postoperative strictures between patients with hernia and those without (p = 0.0124). While postoperative stricture and operative technique were different in the hernia and hernia-free groups on univariate analysis, multivariate logistic analysis revealed that the operative technique was an independent factor for the occurrence of inguinal hernias (p = 0.0419).
  
  
  CONCLUSIONS
  Minilap RRP compares favorably with conventional RRP in view of the postoperative inguinal hernia development.
authors.affiliation: Department of Oncological Science (Urology), Faculty of Medicine, Oita University, Oita, Japan. take@med.oita-u.ac.jp
authors.forename: Takeo
authors.initials: T
authors.lastname: Nomura
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Mimata
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kitamura
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fujikura
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Akita
authors.forename: Mutsushi
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Daisaku
authors.initials: D
authors.lastname: Nakano
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Tasaki
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Nomura
mesh_terms: D000368:Aged; D006552:Hernia, Inguinal / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies