title: A Prospective Nonrandomized Study of Comparison of Perioperative and Quality of Life Outcomes of Endoscopic Versus Open Inguinal Hernia Repair: Data from a Developing Country.
abstract: OBJECTIVE
  To determine the perioperative outcomes and quality of life (QOL) following endoscopic inguinal hernia repair (EIH) versus open inguinal hernia repair (OIH) using the hernia-specific Carolinas Comfort Scale®(CCS) questionnaire.
  
  
  METHODS
  A prospective nonrandomized study from September 2014 to August 2015 included all patients who underwent elective primary endoscopic (totally extraperitoneal repair/transabdominal preperitoneal) or OIH. Baseline patient characteristics were recorded in addition to mean operating time, intraoperative and postoperative complications, return to work, and QOL.
  
  
  RESULTS
  Mean operative duration was significantly longer in EIH compared with OIH (102.5 ± 11.9 minutes versus 66.9 ± 12.7 minutes, P = .001). Mean duration of hospital stay (5.7 ± 1.3 days versus 2.6 ± 0.6 days, P = .001), time to return to routine work (5.8 ± 1.1 days versus 3.7 ± 0.8 days, P = .001), and return to office work (OIH versus EIH: 12.3 ± 1.9 days versus 7.6 ± 0.8 days, P = .001) were significantly shorter in EIH. Intraoperative and postoperative complications were comparable in both the groups, except for surgical site infection, which was more with OIH (20.3% versus 5.6%, P = .04), and postoperative pain scores, which were reduced in EIH. QOL was better in EIH with a significant decrease in terms of sensation of mesh, postoperative pain, and movement limitation.
  
  
  CONCLUSIONS
  Endoscopic hernia repair offers reduced hospital stay, equivocal perioperative complications, reduced postoperative pain, and early return to normal activity and work. This assumes importance in developing countries as most of the patients are the sole earning member in the family. QOL is also significantly improved with endoscopic repair with a considerable change for better with time.
authors.affiliation: Department of Surgery, King George's Medical University , Lucknow, Uttar Pradesh, India .
authors.forename: Awanish
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Surgery, King George's Medical University , Lucknow, Uttar Pradesh, India .
authors.forename: Arvind
authors.initials: A
authors.lastname: Agrahari
authors.affiliation: Department of Surgery, King George's Medical University , Lucknow, Uttar Pradesh, India .
authors.forename: Harvinder Singh
authors.initials: HS
authors.lastname: Pahwa
authors.affiliation: Department of Surgery, King George's Medical University , Lucknow, Uttar Pradesh, India .
authors.forename: Akshay
authors.initials: A
authors.lastname: Anand
authors.affiliation: Department of Surgery, King George's Medical University , Lucknow, Uttar Pradesh, India .
authors.forename: Saumya
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Surgery, King George's Medical University , Lucknow, Uttar Pradesh, India .
authors.forename: Jitendra Kumar
authors.initials: JK
authors.lastname: Kushwaha
authors.affiliation: Department of Surgery, King George's Medical University , Lucknow, Uttar Pradesh, India .
authors.forename: Abhinav Arun
authors.initials: AA
authors.lastname: Sonkar
mesh_terms: D000328:Adult; D000368:Aged; D003906:Developing Countries; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007194:India; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome
keywords: hernia repair; inguinal hernia; intraoperative complications; postoperative complications; quality of life