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Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus Shouldice repair of primary inguinal hernia

Arvidsson, D; Berndsen, FH; Larsson, LG; Leijonmarck, CE; Rimback, G; Rudberg, C; Smedberg, S; Spangen, L and Montgomery, Agneta LU (2005) In British Journal of Surgery 92(9). p.1085-1091
Abstract
Background: The Shouldice technique is the 'gold standard' of open non-mesh hernia repair. The aim of this study was to compare 5-year recurrence rates after Shouldice and laparoscopic transabdominal preperitoneal patch (TAPP) repair for primary inguinal hernia. Method: Men with a primary unilateral inguinal hernia were randomized to either Shouldice or TAPP operation. An independent observer scored the surgeons' performance. Follow-up comprised clinical examination after 1 year, a questionnaire after 2 and 3 years, and a clinical examination after 5 years. Results: Between February 1993 and March 1996, 1183 patients were included. Nine hundred and twenty patients were followed for 5 years, 454 in the TAPP group and 466 in the Shouldice... (More)
Background: The Shouldice technique is the 'gold standard' of open non-mesh hernia repair. The aim of this study was to compare 5-year recurrence rates after Shouldice and laparoscopic transabdominal preperitoneal patch (TAPP) repair for primary inguinal hernia. Method: Men with a primary unilateral inguinal hernia were randomized to either Shouldice or TAPP operation. An independent observer scored the surgeons' performance. Follow-up comprised clinical examination after 1 year, a questionnaire after 2 and 3 years, and a clinical examination after 5 years. Results: Between February 1993 and March 1996, 1183 patients were included. Nine hundred and twenty patients were followed for 5 years, 454 in the TAPP group and 466 in the Shouldice group. Recurrences were evenly distributed between groups throughout the follow-up period. The cumulative recurrence rate after 5 years was 6.6 per cent in the TAPP group and 6.7 per cent in the Shouldice group. Postoperative pain was a risk factor for recurrence after Shouldice operation but not after TAPP repair. There was a correlation between a low surgeon's performance score and recurrence. Conclusion: The 5-year recurrence rate is acceptable, with no difference between TAPP and Shouldice repair. Poor operative performance resulted in a higher recurrence rate. The TAPP operation represents an excellent alternative for primary inguinal hernia repair. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
British Journal of Surgery
volume
92
issue
9
pages
1085 - 1091
publisher
John Wiley & Sons
external identifiers
  • wos:000231836500006
  • pmid:16106480
  • scopus:24644508919
ISSN
1365-2168
DOI
10.1002/bjs.5137
language
English
LU publication?
yes
id
213a0a7c-b5e5-4c4e-bf64-c1edd5361893 (old id 891691)
date added to LUP
2008-01-11 11:04:09
date last changed
2017-10-01 03:35:36
@article{213a0a7c-b5e5-4c4e-bf64-c1edd5361893,
  abstract     = {Background: The Shouldice technique is the 'gold standard' of open non-mesh hernia repair. The aim of this study was to compare 5-year recurrence rates after Shouldice and laparoscopic transabdominal preperitoneal patch (TAPP) repair for primary inguinal hernia. Method: Men with a primary unilateral inguinal hernia were randomized to either Shouldice or TAPP operation. An independent observer scored the surgeons' performance. Follow-up comprised clinical examination after 1 year, a questionnaire after 2 and 3 years, and a clinical examination after 5 years. Results: Between February 1993 and March 1996, 1183 patients were included. Nine hundred and twenty patients were followed for 5 years, 454 in the TAPP group and 466 in the Shouldice group. Recurrences were evenly distributed between groups throughout the follow-up period. The cumulative recurrence rate after 5 years was 6.6 per cent in the TAPP group and 6.7 per cent in the Shouldice group. Postoperative pain was a risk factor for recurrence after Shouldice operation but not after TAPP repair. There was a correlation between a low surgeon's performance score and recurrence. Conclusion: The 5-year recurrence rate is acceptable, with no difference between TAPP and Shouldice repair. Poor operative performance resulted in a higher recurrence rate. The TAPP operation represents an excellent alternative for primary inguinal hernia repair.},
  author       = {Arvidsson, D and Berndsen, FH and Larsson, LG and Leijonmarck, CE and Rimback, G and Rudberg, C and Smedberg, S and Spangen, L and Montgomery, Agneta},
  issn         = {1365-2168},
  language     = {eng},
  number       = {9},
  pages        = {1085--1091},
  publisher    = {John Wiley & Sons},
  series       = {British Journal of Surgery},
  title        = {Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus Shouldice repair of primary inguinal hernia},
  url          = {http://dx.doi.org/10.1002/bjs.5137},
  volume       = {92},
  year         = {2005},
}