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Low Recurrence Rate After Laparoscopic (TEP) and Open (Lichtenstein) Inguinal Hernia Repair A Randomized, Multicenter Trial With 5-Year Follow-Up

Eklund, Arne S.; Montgomery, Agneta LU ; Rasmussen, Ib C.; Sandbue, Rune P.; Bergkvist, Leif A. and Rudberg, Clues R. (2009) In Annals of Surgery 249(1). p.33-38
Abstract
Objectives: To compare a laparoscopic (totally extraperitoneal patch (TEP)) and an open technique (Lichtenstein) for inguinal hernia repair regarding recurrence rate and possible risk factors for recurrence. Summary Background Data: Laparoscopic hernia repair has been introduced as an alternative to open repair. Short-term follow-tip suggests benefits for those patients operated with a laparoscopic approach compared with open techniques; ie, less postoperative pain and a shorter convalescence period. Long-term results, however, arc less well known. Methods: The study was conducted as a Multicenter randomized trial with a 5-year follow-up. A total of 1512 men aged 30 to 70 years, with a primary unilateral inguinal hernia, were randomized to... (More)
Objectives: To compare a laparoscopic (totally extraperitoneal patch (TEP)) and an open technique (Lichtenstein) for inguinal hernia repair regarding recurrence rate and possible risk factors for recurrence. Summary Background Data: Laparoscopic hernia repair has been introduced as an alternative to open repair. Short-term follow-tip suggests benefits for those patients operated with a laparoscopic approach compared with open techniques; ie, less postoperative pain and a shorter convalescence period. Long-term results, however, arc less well known. Methods: The study was conducted as a Multicenter randomized trial with a 5-year follow-up. A total of 1512 men aged 30 to 70 years, with a primary unilateral inguinal hernia, were randomized to either TEP or Lichtenstein repair. Results: Overall, 665 patients in the TEP group and 705 patients in the Lichtenstein group were evaluable. The cumulative recurrence rate was 3.5% in the TEP group and 1.2% in the Lichtenstein group (P = 0.0081). Test For heterogeneity revealed significant differences between individual Surgeons. The exclusion of 1 surgeon, who was responsible for 33% (7 of 21) of all recurrences in the TEP group, lowered the cumulative recurrence rate to 2.4% in this group, which was not statistically different front that of the Lichtenstein group. Conclusions: The recurrence rate for both TEP and Lichtenstein repair was low. A higher cumulative recurrence rate in the TEP group was seen at 5 years. Further analysis revealed that this could be attributable to incorrect surgical technique. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Annals of Surgery
volume
249
issue
1
pages
33 - 38
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000262219300007
  • scopus:58749087101
ISSN
1528-1140
DOI
10.1097/SLA.0b013e31819255d0
language
English
LU publication?
yes
id
eb072add-62e9-4d37-9e53-b225fe70ea8a (old id 1313471)
date added to LUP
2009-03-09 15:53:55
date last changed
2017-10-01 03:43:03
@article{eb072add-62e9-4d37-9e53-b225fe70ea8a,
  abstract     = {Objectives: To compare a laparoscopic (totally extraperitoneal patch (TEP)) and an open technique (Lichtenstein) for inguinal hernia repair regarding recurrence rate and possible risk factors for recurrence. Summary Background Data: Laparoscopic hernia repair has been introduced as an alternative to open repair. Short-term follow-tip suggests benefits for those patients operated with a laparoscopic approach compared with open techniques; ie, less postoperative pain and a shorter convalescence period. Long-term results, however, arc less well known. Methods: The study was conducted as a Multicenter randomized trial with a 5-year follow-up. A total of 1512 men aged 30 to 70 years, with a primary unilateral inguinal hernia, were randomized to either TEP or Lichtenstein repair. Results: Overall, 665 patients in the TEP group and 705 patients in the Lichtenstein group were evaluable. The cumulative recurrence rate was 3.5% in the TEP group and 1.2% in the Lichtenstein group (P = 0.0081). Test For heterogeneity revealed significant differences between individual Surgeons. The exclusion of 1 surgeon, who was responsible for 33% (7 of 21) of all recurrences in the TEP group, lowered the cumulative recurrence rate to 2.4% in this group, which was not statistically different front that of the Lichtenstein group. Conclusions: The recurrence rate for both TEP and Lichtenstein repair was low. A higher cumulative recurrence rate in the TEP group was seen at 5 years. Further analysis revealed that this could be attributable to incorrect surgical technique.},
  author       = {Eklund, Arne S. and Montgomery, Agneta and Rasmussen, Ib C. and Sandbue, Rune P. and Bergkvist, Leif A. and Rudberg, Clues R.},
  issn         = {1528-1140},
  language     = {eng},
  number       = {1},
  pages        = {33--38},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Annals of Surgery},
  title        = {Low Recurrence Rate After Laparoscopic (TEP) and Open (Lichtenstein) Inguinal Hernia Repair A Randomized, Multicenter Trial With 5-Year Follow-Up},
  url          = {http://dx.doi.org/10.1097/SLA.0b013e31819255d0},
  volume       = {249},
  year         = {2009},
}