title: Quantitative assessment of the impacts of stoppa repair and total extraperitoneal repair on the lower extremity muscular functions in cases of unilateral inguinal hernia: a randomized controlled study.
abstract: Choosing the best operative technique for unilateral inguinal hernia is a challenge for surgeons. Therefore, anticipating loss of strength in the lower extremity muscles could be the initial step to make the right decision. To this end, this prospective randomized controlled study compared the physical activity parameters of the lower extremity muscles in patients who underwent total extraperitoneal repair (TEP) and Stoppa repair.
  
  
  
  Fifty patients with unilateral inguinal hernia who were 18-65 years of age were admitted to a single institution in a metropolitan city in Turkey. Patients were randomized in a 1:1 ratio to parallel study arms of TEP and STOPPA repair. They were evaluated in the preoperative period and on the postoperative day 3 for an objective isometric and isokinetic assessment of the pain-related functional changes in the lower extremity muscles.
  
  
  
  The measurement results obtained with the Cybex device on the postoperative day 3 were presented as numeric parameters in the digital setting, where the Stoppa repair resulted in a higher loss of strength in the lower extremities compared to the TEP repair. With respect to the total workforce loss in isokinetic muscular measurements at 90 °C/s extension, 90 °C/s flexion, 180 °C/s extension and 180 °C/s flexion, the difference between the TEP repair and Stoppa repair was statistically significant in favor of TEP repair (p < 0.05).
  
  
  
  This study is the first comparative study in the literature to demonstrate the favorable impact of the laparoscopic hernia repair on the physical activity on the same anatomic site compared to the open surgical procedure by using quantitative values.
  
  
  
  Clinicaltrials.gov ID: NCT02813057.
authors.affiliation: Department of General Surgery, Agri State Hospital, Agri, Turkey. nedimakgul@yahoo.com.|Dumlupınar Bulvari, Akdeniz Universitesi Hastanesi, Genel Cerrahi AD, Kampus, 07059, Antalya, Turkey. nedimakgul@yahoo.com.
authors.forename: N
authors.initials: N
authors.lastname: Akgül
authors.affiliation: Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Yaprak
authors.affiliation: Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: V
authors.initials: V
authors.lastname: Doğru
authors.affiliation: Department of Physical Medicine and Rehabilitation, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Balci
authors.affiliation: Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Arici
authors.affiliation: Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Mesci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010149:Postoperative Pain / Q000503:physiopathology*; D011184:Postoperative Period; D011446:Prospective Studies; D020127:Recovery of Function; D055815:Young Adult
keywords: Cybex device; Laparoscopy; Physical activity; Stoppa; TEP; Unilateral inguinal hernia