Sixty-month follow-up after endoscopic inguinal hernia repair with three types of mesh: a prospective randomized trial.
BACKGROUND
This prospective, clinical, randomized, double-blind study was intended to investigate the impact of the structure and the amount of polypropylene (PP) mesh used in laparoscopic transabdominal preperitoneal hernioplastic (TAPP) on physical function and life quality.


METHODS
180 male patients with primary inguinal hernia undergoing TAPP were randomized for using a heavyweight (108 g/m(2)), double-filament PP mesh (Prolene, 10 x 15 cm, group A, n = 60), a multifilament, heavyweight variant (116 g/m(2)) of PP mesh (Serapren, 10 x 15 cm, group B, n = 60), or a composite mesh (polyglactin and PP) (Vypro II, 10 x 15 cm, group C, n = 60). We compared in terms of complications (seromas, recurrence rate) and life quality (pain development, physical function). The development of life quality was documented according to the SF-36 Health Survey. The follow-up period was 60 months.


RESULTS
The recurrence rate (2.2% overall) during 60-month follow-up was not significantly different between the groups. Convalescence in group A was slower than in groups B and C: mean-term values of the visual scales for pain development were significantly (p < 0.05) higher, incapacity for work was 8.2 days longer, and urological adverse effects were stronger. The mean-term development of life quality was significantly lower in group A up to 12th week postoperatively. There were no significant differences between groups B and C. Beyond the 12th postinterventional week the differences diminished.


CONCLUSIONS
The composite mesh does not provide an advantage concerning physical function or pain development in comparison to the multifilament, heavyweight, pure polypropylene mesh. Independently of which mesh was implanted 5% of patients are still suffering from discomfort after 5 years.
Langenbach
Mike Ralf
MR
Department of Surgery, Helios Klinikum Wuppertal, University of Witten-Herdecke, Heusner-Strasse 40, 42283, Wuppertal, Germany. mike-ralf.langenbach@helios-kliniken.de
Schmidt
Johannes
J
Ubrig
Burkhard
B
Zirngibl
Hubert
H
D004311:Double-Blind Method; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000503:physiopathology; D011126:Polypropylenes; D011184:Postoperative Period; D011788:Quality of Life; D012008:Recurrence; D013526:Surgical Mesh / Q000009:adverse effects / Q000145:classification; D014570:Urologic Diseases / Q000209:etiology; D014938:Work Capacity Evaluation
D011126:Polypropylenes