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Long term inguinal pain comparing TEP to Lichtenstein repair : the TEPLICH RCT 8 years follow-up

Gutlic, A. LU orcid ; Petersson, U. LU ; Rogmark, P. LU orcid and Montgomery, A. LU (2025) In Hernia 29(1).
Abstract

Purpose: To investigate long-term chronic postoperative inguinal pain (CPIP), QoL and recurrence in patients with a primary inguinal hernia comparing TEP to Lichtenstein. Material and methods: A questionnaire-based follow-up containing the Inguinal Pain Questionnaire (IPQ), the Cunningham Pain Scale and SF-36 was done 8 years after the TEPLICH RCT. The main objective was non-ignorable pain last week according to IPQ. A phone interview was performed with patients reporting new non-ignorable pain and those having a suspected recurrence. Records were scanned for long-term CPIP and recurrences. A lost to follow-up analysis was performed. Results: A total of 322 of 366 patients (88%) completed the follow-up of mean 7.94 years (5–10.75... (More)

Purpose: To investigate long-term chronic postoperative inguinal pain (CPIP), QoL and recurrence in patients with a primary inguinal hernia comparing TEP to Lichtenstein. Material and methods: A questionnaire-based follow-up containing the Inguinal Pain Questionnaire (IPQ), the Cunningham Pain Scale and SF-36 was done 8 years after the TEPLICH RCT. The main objective was non-ignorable pain last week according to IPQ. A phone interview was performed with patients reporting new non-ignorable pain and those having a suspected recurrence. Records were scanned for long-term CPIP and recurrences. A lost to follow-up analysis was performed. Results: A total of 322 of 366 patients (88%) completed the follow-up of mean 7.94 years (5–10.75 years). Non-ignorable pain last week was reported by 7.6% in TEP and 6.7% in Lichtenstein (p < 0.73). New non-ignorable pain was reported by 5 patients. No difference in non-ignorable pain over time (1–8 years) was observed within groups. Moderate to severe pain, according to Cunningham, was reported by 3.8% in TEP and 5.5% in Lichtenstein (p < 0.48). QoL remained above the Swedish norm. No recurrences occurred after 3 years follow-up. The lost to follow-up analysis showed no difference in non-ignorable pain. Conclusions: RCTs, comparing TEP to Lichtenstein repair with follow-up ≥ 5 years regarding CPIP are sparse with conflicting data. In this study, low frequencies of CPIP present at 3 years seem to persist at 8 years. Recurrences occured within the first 3 years. Patients need to be informed of the risk of long-term CPIP.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chronic pain, Inguinal hernia, Lichtenstein, QoL, Recurrence, TEP
in
Hernia
volume
29
issue
1
article number
49
publisher
Springer
external identifiers
  • scopus:85212772599
  • pmid:39699700
ISSN
1265-4906
DOI
10.1007/s10029-024-03246-y
language
English
LU publication?
yes
id
738d8349-6301-4d6c-a7be-368bc39a0b3f
date added to LUP
2025-03-03 11:09:55
date last changed
2025-07-08 08:40:40
@article{738d8349-6301-4d6c-a7be-368bc39a0b3f,
  abstract     = {{<p>Purpose: To investigate long-term chronic postoperative inguinal pain (CPIP), QoL and recurrence in patients with a primary inguinal hernia comparing TEP to Lichtenstein. Material and methods: A questionnaire-based follow-up containing the Inguinal Pain Questionnaire (IPQ), the Cunningham Pain Scale and SF-36 was done 8 years after the TEPLICH RCT. The main objective was non-ignorable pain last week according to IPQ. A phone interview was performed with patients reporting new non-ignorable pain and those having a suspected recurrence. Records were scanned for long-term CPIP and recurrences. A lost to follow-up analysis was performed. Results: A total of 322 of 366 patients (88%) completed the follow-up of mean 7.94 years (5–10.75 years). Non-ignorable pain last week was reported by 7.6% in TEP and 6.7% in Lichtenstein (p &lt; 0.73). New non-ignorable pain was reported by 5 patients. No difference in non-ignorable pain over time (1–8 years) was observed within groups. Moderate to severe pain, according to Cunningham, was reported by 3.8% in TEP and 5.5% in Lichtenstein (p &lt; 0.48). QoL remained above the Swedish norm. No recurrences occurred after 3 years follow-up. The lost to follow-up analysis showed no difference in non-ignorable pain. Conclusions: RCTs, comparing TEP to Lichtenstein repair with follow-up ≥ 5 years regarding CPIP are sparse with conflicting data. In this study, low frequencies of CPIP present at 3 years seem to persist at 8 years. Recurrences occured within the first 3 years. Patients need to be informed of the risk of long-term CPIP.</p>}},
  author       = {{Gutlic, A. and Petersson, U. and Rogmark, P. and Montgomery, A.}},
  issn         = {{1265-4906}},
  keywords     = {{Chronic pain; Inguinal hernia; Lichtenstein; QoL; Recurrence; TEP}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Springer}},
  series       = {{Hernia}},
  title        = {{Long term inguinal pain comparing TEP to Lichtenstein repair : the TEPLICH RCT 8 years follow-up}},
  url          = {{http://dx.doi.org/10.1007/s10029-024-03246-y}},
  doi          = {{10.1007/s10029-024-03246-y}},
  volume       = {{29}},
  year         = {{2025}},
}