title: The effect of transabdominal preperitoneal (TAPP) inguinal hernioplasty on chronic pain and quality of life of patients: mesh fixation versus non-fixation.
abstract: OBJECTIVE
  The aim of this study was to compare the effect of transabdominal preperitoneal (TAPP) inguinal hernioplasty with or without mesh fixation on chronic pain and quality of life of patients.
  
  
  METHODS
  One hundred patients with a simple oblique inguinal hernia were included and treated at the Second Affiliated Hospital of Kunming Medical University from July of 2015 to July of 2016. Patients were randomly assigned to TAPP inguinal hernioplasty with mesh fixation (fixation group, n = 50) or without mesh fixation (non-fixation group, n = 50). Observation indices such as mean operative time, time to ambulation, hospitalization expense, and complications were recorded. The visual analog scale (VAS) was adopted for pain evaluation 2 days, 3 months, and 6 months postoperatively. The 36-item short-form health survey (SF-36) was adopted for life quality scoring 3 months postoperatively.
  
  
  RESULTS
  No recurrence or incisional infections were observed during follow-up in either group. The mean operative time, time to ambulation, and hospitalization expense of the non-fixation group were all significantly reduced compared to those of the fixation group. The VAS score 2 days, 3 months, and 6 months postoperatively of the non-fixation group were significantly lower than in the fixation group. The physical function, role physical, bodily pain, and general health in the non-fixation group were each significantly higher than in the fixation group. In contrast, vitality, social function, role emotional, and mental health showed no significant differences across groups.
  
  
  CONCLUSIONS
  For patients with primary unilateral oblique inguinal hernia with a defect size less than 4.0 cm in diameter, TAPP inguinal hernioplasty without mesh fixation was safe and effective. Furthermore, this shortened the operative time, promoted early ambulation, decreased hospitalization expenses, alleviated postoperative pain, and improved quality of life.
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China.
authors.forename: Weiming
authors.identifier: http://orcid.org/0000-0001-9220-514X
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China.
authors.forename: Dali
authors.initials: D
authors.lastname: Sun
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China.
authors.forename: Yanbo
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Cen
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China.
authors.forename: Shumin
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China.
authors.forename: Qingwen
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China.
authors.forename: Yijun
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China.
authors.forename: Yuxing
authors.initials: Y
authors.lastname: Qi
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China.
authors.forename: Yueying
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Gastrointestinal Surgery, Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Road, Kunming, 650101, Yunnan Province, China. pyxu778@sina.com.
authors.forename: Pengyuan
authors.initials: P
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D006552:Hernia, Inguinal / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life; D013526:Surgical Mesh / Q000009:adverse effects; D016896:Treatment Outcome; D064232:Visual Analog Scale
keywords: Hernia; Inguinal; Laparoscopic; Life quality; Non-fixation; Tension-free