Early assessment of bilateral inguinal hernia repair: A comparison between the laparoscopic total extraperitoneal and Stoppa approaches.
BACKGROUND
The present clinical trial was designed to compare the results of bilateral inguinal hernia repair between patients who underwent the conventional Stoppa technique and laparoscopic total extraperitoneal repair (LTE) with a single mesh and without staple fixation.


METHODS
This controlled, randomised clinical trial was conducted at General Surgery and Trauma of the Clinics Hospital, Medical School, the University of São Paulo between September 2010 and February 2011. Totally, 50 male patients, with a bilateral inguinal hernia, older than 25 years were considered eligible for the study. The following parameters were analysed during the early post-operative period: (1) The intensity of surgical trauma, operation time, C-reactive protein (CRP) levels, white blood cell count, bleeding and pain intensity; (2) quality of life assessment; and (3) post-operative complications.


RESULTS
LTE procedure was longer than the Stoppa procedure (134.6 min ± 38.3 vs. 90.6 min ± 41.3; P < 0.05). The levels of CRP were higher in the Stoppa group (P < 0.05) but the number of leucocytes, haematocrit, and haemoglobin were similar between the groups (P > 0.05). There was no difference in pain during the 1st and 7th post-operative, physical functioning, physical limitation, the impact of pain on daily activities, and the Carolinas Comfort Scale during the 7th and 15th post-operative (P > 0.05). Complications occurred in 88% of Stoppa group (22 patients) and 64% in LTE group (16 patients) (P < 0.05).


CONCLUSIONS
The comparative study between the Stoppa and LTE approaches for the bilateral inguinal hernia repair demonstrated that: (1) The LTE approach showed less surgical trauma despite the longer operation time; (2) Quality of life during the early post-operative period were similar; and (3) Complication rates were higher in the Stoppa group.
Associate Professor of Surgery, Department of Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Edivaldo Massazo
EM
Utiyama
Physican of General and Trauma Surgery in Hospital das Clínicas da Faculdade de Medicna da Universidade de São Paulo, São Paulo, Brazil.
S Rgio Henrique Bastos
SR
Damous
Physican of General and Trauma Surgery in Hospital das Clínicas da Faculdade de Medicna da Universidade de São Paulo, São Paulo, Brazil.
Eduardo Yassushi
EY
Tanaka
Physican of General and Trauma Surgery in Hospital das Clínicas da Faculdade de Medicna da Universidade de São Paulo, São Paulo, Brazil.
Jin Hwan
JH
Yoo
Physican of General and Trauma Surgery in Hospital das Clínicas da Faculdade de Medicna da Universidade de São Paulo, São Paulo, Brazil.
Jocielle Santos
JS
de Miranda
Physican of General and Trauma Surgery in Hospital das Clínicas da Faculdade de Medicna da Universidade de São Paulo, São Paulo, Brazil.
Adriano Zuardi
AZ
Ushinohama
Physican of General and Trauma Surgery in Hospital das Clínicas da Faculdade de Medicna da Universidade de São Paulo, São Paulo, Brazil.
Mario Paulo
MP
Faro
Physican of General and Trauma Surgery in Hospital das Clínicas da Faculdade de Medicna da Universidade de São Paulo, São Paulo, Brazil.
Claudio Augusto Vianna
CA
Birolini