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Can laparoscopic total extraperitoneal repair of inguinal hernia be preferred to conventional method? A randomized clinical trial

Year 2013, Volume: 4 Issue: 1, 80 - 83, 01.03.2013
https://doi.org/10.5799/ahinjs.01.2013.01.0238

Abstract

Objective: This is a prospective study of laparoscopic to­tally extraperitoneal (TEP) inguinal hernia repair to com­pare with the conventional method of Lichtenstein. Methods: A total of 50 patient (25 conventional, 25 lapa­roscopic) with inguinal hernia were included. We were examined prospectively age, gender, body mass index (BMI), inguinal hernia type (Nyhus classification), Ameri­can Society of Anesthesiologists risk score (ASA), the first skin incision until closure operation time, intraopera­tive and postoperative complications, postoperative pain score, analgesic requirement, hospital stay, return to nor­mal physical activity in terms of duration and recurrence on preoperative patient. Visual analog pain score (VAS) were used for scoring pain for all patients. Results: 46 patients (92%) were male and mean age was 50.9 years (range 17-78). The mean BMI was 25,8 kg/m2 (range 19.1-31,6) and there was no significant difference in demographic characteristics between groups (p>0,05). In both groups, mainly Nyhus Type 2 was followed and there was no significant difference in ASA scores and hernia type between the groups (p>0.05). Laparoscopic group was more advantageous in analgesic use, VAS score, and return to work time, but had longer operation time (p0.05). Conclusions: Although laparoscopic TEP hernia repair had longer operation time; it provides less pain, less an­algesic use with similar morbidity rate and provides early discharge. J Clin Exp Invest 2013; 4 (1): 80-83

References

  • Kahramansoy N, Büyükaşık O, Erkol H, et al. İleri yaş hastalarda lokal anestezi altında kasık fıtığı tamiri. Dicle Med J 2012; 3:513-517.
  • Scott NW, McCormack K, Graham P, et al. Open mesh versus nonmesh for repair of femoral and inguinal her- nia. Cochrane Database Syst Rev 2002;CD002197.
  • Kuhry E, van Veen RN, Langeveld HR, et al. Open or endoscopic total extraperitoneal inguinal hernia re- pair? A systematic review. Surg Endosc. 2007;21:161- 166.
  • Feliu-Pal`a X, Mart´ın-Gomez M, Morales-Conde S, et al. The impact of the surgeon’s experience on the results of laparoscopic hernia repair. Surg Endosc 2001;15:1467-1470.
  • Lau H, Patil NG, Yuen WK, et al. Management of peri- toneal tear during endoscopic extraperitoneal inguinal hernioplasty. Surg Endosc 2002;16:1474-1477.
  • Dulucq JL, Wintringer P, Mahajna A. Laparoscopic to- tally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years. Surg Endosc. 2009;23:482-486.
  • Heikkinen T, Bringman S, Ohtonen P, et al. Five-year outcome of laparoscopic and Lichtenstein hernioplas- ties. Surg Endosc 2004;18:518-522.
  • Eklund A, Rudberg C, Smedberg S, et al. Short-term re- sults of a randomized clinical trial comparing Lichten- stein open repair with totally extraperitoneal laparo- scopic inguinal hernia repair. Br J Surg 2006;93:1060- 1068.
  • Stylopoulos N, Gazelle GS, Rattner DW. A cost-utility analysis of treatment options for inguinal hernia in 1,513,008 adult patients. Surg Endosc 2003;17:180- 189.
  • Jacobs VR, Morrison JE Jr. Comparison of institu- tional costs for laparoscopic preperitoneal inguinal hernia versus open repair and its reimbursement in an ambulatory surgery center. Surg Laparosc Endosc Percutan Tech 2008;18:70-74.
  • Schneider BE, Castillo JM, Villegas L, et al. Lapa- roscopic totally extraperitoneal versus Lichtenstein herniorrhaphy: cost comparison at teaching hospitals. Surg Laparosc Endosc Percutan Tech 2003;13:261- 267.
  • EU Hernia Trialists Collaboration. Repair of groin her- nia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg 2002;235:322-332.
  • McCormack K, Scott NW, Go PM, et al. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 2003;CD001785.
  • Wara P, Bay-Nielsen M, Juul P, et al. Prospective na- tionwide analysis of laparoscopic versus Lichtenstein repair of inguinal hernia. Br J Surg 2005;92:1277- 1281.
  • Lauscher JC, Yafaei K, Buhr HJ, et al. Laparoscopic and open inguinal hernia repair with alloplastic mate- rial: do the subjective and objective parameters differ in the long-term course? Surg Laparosc Endosc Per- cutan Tech 2008;18:457-463.
  • Karthikesalingam A, Markar SR, Holt PJ, et al. Meta- analysis of randomized controlled trials comparing laparoscopic with open mesh repair ofrecurrent ingui- nal hernia. Br J Surg 2010;97:4-11.
  • Barrat C, Surlin V, Bordia A, et al. Management of recurrent inguinal hernias: a prospective study of 163 cases. Hernia. 2003;7:125-129.
  • Nienhuijs S, Staal E, Keemers-Gels M, et al. Pain after open preperitoneal repair versus Lichtenstein repair: a randomized trial. World J Surg 2007;31:1751-1757.
  • Hernandez-Rosa J, Lo CC, Choi JJ, et al. Laparo- scopic versus open inguinal hernia repair in octoge- narians. Hernia 2011;15:655-658.
  • Lau H, Patil NG, Yuen WK. Day-case endoscopic to- tally extraperitoneal inguinal hernioplasty versus open Lichtenstein hernioplasty for unilateral primary ingui- nal hernia in males: a randomized trial. Surg Endosc 2006;20:76-81.
  • Grant AM, Scott NW, O’Dwyer PJ; MRC Laparoscopic Groin Hernia Trial Group. Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 2004;91:1570-1574.
  • Takata MC, Duh QY. Laparoscopic inguinal hernia re- pair. Surg Clin North Am 2008;88:157-178.
  • Rosen MJ, Novitsky YW, Cobb WS, et al. Combined open and laparoscopic approach to chronic pain fol- lowing open inguinal hernia repair. Hernia 2006;10:20- 24.
  • Lal P, Kajla RK, Chander J, et al. Randomized con- trolled study of laparoscopic total extraperitoneal ver- sus open Lichtenstein inguinal hernia repair. Surg En- dosc 2003;17:850-856.

Laparoskopik total ekstraperitoneal kasık fıtığı tamiri konvansiyonel yönteme tercih edilebilir mi? Randomize klinik çalışma

Year 2013, Volume: 4 Issue: 1, 80 - 83, 01.03.2013
https://doi.org/10.5799/ahinjs.01.2013.01.0238

Abstract

Amaç: Bu çalışmada prospektif olarak laparoskopik total ekstraperitoneal (TEP) kasık fıtığı onarımı ile konvansi­yonel Lichtenstein yöntemi karşılaştırmak amaçlanmıştır. Yöntemler: Kasık fıtıklı 50 olgu (25 konvansiyonel, 25 laparoskopik) çalışmaya alındı. Prospektif olarak ame­liyat öncesi olgulara ait yaş, cinsiyet, vücut kitle indek­si (BMI), kasık fıtığı türü (Nyhus sınıflaması), Amerikan Anesteziyoloji Derneği risk skorlaması (ASA), ilk cilt in­sizyonundan kapatılmaya kadar geçen ameliyat süreleri, peroperatif ve postoperatif komplikasyonlar, postoperatif dönemde ağrı skoru, analjezik ihtiyacı, hastanede kalış süresi, normal fizik aktiviteye dönüş süreleri ve nüks açı­sından incelenmiştir. Hastaların tümünün ağrı skorlaması için vizüel analog skala (VAS) kullanılmıştır. Bulgular: Olguların 46(%92)\'si erkek olup ortalama yaş 50,9 (17-78) idi. Sırası ile ortalama BMI değerleri 25,7 ve 25,8 olan gruplar arası demografik özellikler bakımın­dan fark veya istatiksel anlamlılık yoktu (p>0,05). Her iki grupta da ağırlıklı olarak Nyhus Tip 2 izlenmiş olup; fıtık türü ve ASA skorları arasında istatistiksel olarak anlamlı ilişki gözlenmedi (p>0,05). Laparoskopik teknik kullanı­lan grup, konvansiyel gruba göre operasyon süresi daha uzun olmakla birlikte; analjezik kullanımı, VAS skoru, ta­burculuk süresi ve işe dönüş zamanı bakımından daha avantajlı görüldü (p0,05). Sonuç: Laparoskopik TEP fıtık tamiri uzun ameliyat sü­relerine karşın olgunun daha az ağrı duymasını, daha az analjezik kullanımını, benzer morbidite oranı ile erken ta­burculuğunu sağlamaktadır.

References

  • Kahramansoy N, Büyükaşık O, Erkol H, et al. İleri yaş hastalarda lokal anestezi altında kasık fıtığı tamiri. Dicle Med J 2012; 3:513-517.
  • Scott NW, McCormack K, Graham P, et al. Open mesh versus nonmesh for repair of femoral and inguinal her- nia. Cochrane Database Syst Rev 2002;CD002197.
  • Kuhry E, van Veen RN, Langeveld HR, et al. Open or endoscopic total extraperitoneal inguinal hernia re- pair? A systematic review. Surg Endosc. 2007;21:161- 166.
  • Feliu-Pal`a X, Mart´ın-Gomez M, Morales-Conde S, et al. The impact of the surgeon’s experience on the results of laparoscopic hernia repair. Surg Endosc 2001;15:1467-1470.
  • Lau H, Patil NG, Yuen WK, et al. Management of peri- toneal tear during endoscopic extraperitoneal inguinal hernioplasty. Surg Endosc 2002;16:1474-1477.
  • Dulucq JL, Wintringer P, Mahajna A. Laparoscopic to- tally extraperitoneal inguinal hernia repair: lessons learned from 3,100 hernia repairs over 15 years. Surg Endosc. 2009;23:482-486.
  • Heikkinen T, Bringman S, Ohtonen P, et al. Five-year outcome of laparoscopic and Lichtenstein hernioplas- ties. Surg Endosc 2004;18:518-522.
  • Eklund A, Rudberg C, Smedberg S, et al. Short-term re- sults of a randomized clinical trial comparing Lichten- stein open repair with totally extraperitoneal laparo- scopic inguinal hernia repair. Br J Surg 2006;93:1060- 1068.
  • Stylopoulos N, Gazelle GS, Rattner DW. A cost-utility analysis of treatment options for inguinal hernia in 1,513,008 adult patients. Surg Endosc 2003;17:180- 189.
  • Jacobs VR, Morrison JE Jr. Comparison of institu- tional costs for laparoscopic preperitoneal inguinal hernia versus open repair and its reimbursement in an ambulatory surgery center. Surg Laparosc Endosc Percutan Tech 2008;18:70-74.
  • Schneider BE, Castillo JM, Villegas L, et al. Lapa- roscopic totally extraperitoneal versus Lichtenstein herniorrhaphy: cost comparison at teaching hospitals. Surg Laparosc Endosc Percutan Tech 2003;13:261- 267.
  • EU Hernia Trialists Collaboration. Repair of groin her- nia with synthetic mesh: meta-analysis of randomized controlled trials. Ann Surg 2002;235:322-332.
  • McCormack K, Scott NW, Go PM, et al. Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 2003;CD001785.
  • Wara P, Bay-Nielsen M, Juul P, et al. Prospective na- tionwide analysis of laparoscopic versus Lichtenstein repair of inguinal hernia. Br J Surg 2005;92:1277- 1281.
  • Lauscher JC, Yafaei K, Buhr HJ, et al. Laparoscopic and open inguinal hernia repair with alloplastic mate- rial: do the subjective and objective parameters differ in the long-term course? Surg Laparosc Endosc Per- cutan Tech 2008;18:457-463.
  • Karthikesalingam A, Markar SR, Holt PJ, et al. Meta- analysis of randomized controlled trials comparing laparoscopic with open mesh repair ofrecurrent ingui- nal hernia. Br J Surg 2010;97:4-11.
  • Barrat C, Surlin V, Bordia A, et al. Management of recurrent inguinal hernias: a prospective study of 163 cases. Hernia. 2003;7:125-129.
  • Nienhuijs S, Staal E, Keemers-Gels M, et al. Pain after open preperitoneal repair versus Lichtenstein repair: a randomized trial. World J Surg 2007;31:1751-1757.
  • Hernandez-Rosa J, Lo CC, Choi JJ, et al. Laparo- scopic versus open inguinal hernia repair in octoge- narians. Hernia 2011;15:655-658.
  • Lau H, Patil NG, Yuen WK. Day-case endoscopic to- tally extraperitoneal inguinal hernioplasty versus open Lichtenstein hernioplasty for unilateral primary ingui- nal hernia in males: a randomized trial. Surg Endosc 2006;20:76-81.
  • Grant AM, Scott NW, O’Dwyer PJ; MRC Laparoscopic Groin Hernia Trial Group. Five-year follow-up of a randomized trial to assess pain and numbness after laparoscopic or open repair of groin hernia. Br J Surg 2004;91:1570-1574.
  • Takata MC, Duh QY. Laparoscopic inguinal hernia re- pair. Surg Clin North Am 2008;88:157-178.
  • Rosen MJ, Novitsky YW, Cobb WS, et al. Combined open and laparoscopic approach to chronic pain fol- lowing open inguinal hernia repair. Hernia 2006;10:20- 24.
  • Lal P, Kajla RK, Chander J, et al. Randomized con- trolled study of laparoscopic total extraperitoneal ver- sus open Lichtenstein inguinal hernia repair. Surg En- dosc 2003;17:850-856.
There are 24 citations in total.

Details

Primary Language Turkish
Journal Section Research Article
Authors

Hacı Osman Tanrıverdi This is me

Fevzi Cengiz This is me

Savaş Yakan This is me

Abdullah Şenlikçi This is me

Mehmet Akif Üstüner This is me

Enver İlhan This is me

Publication Date March 1, 2013
Published in Issue Year 2013 Volume: 4 Issue: 1

Cite

APA Tanrıverdi, H. O., Cengiz, F., Yakan, S., Şenlikçi, A., et al. (2013). Laparoskopik total ekstraperitoneal kasık fıtığı tamiri konvansiyonel yönteme tercih edilebilir mi? Randomize klinik çalışma. Journal of Clinical and Experimental Investigations, 4(1), 80-83. https://doi.org/10.5799/ahinjs.01.2013.01.0238
AMA Tanrıverdi HO, Cengiz F, Yakan S, Şenlikçi A, Üstüner MA, İlhan E. Laparoskopik total ekstraperitoneal kasık fıtığı tamiri konvansiyonel yönteme tercih edilebilir mi? Randomize klinik çalışma. J Clin Exp Invest. March 2013;4(1):80-83. doi:10.5799/ahinjs.01.2013.01.0238
Chicago Tanrıverdi, Hacı Osman, Fevzi Cengiz, Savaş Yakan, Abdullah Şenlikçi, Mehmet Akif Üstüner, and Enver İlhan. “Laparoskopik Total Ekstraperitoneal kasık fıtığı Tamiri Konvansiyonel yönteme Tercih Edilebilir Mi? Randomize Klinik çalışma”. Journal of Clinical and Experimental Investigations 4, no. 1 (March 2013): 80-83. https://doi.org/10.5799/ahinjs.01.2013.01.0238.
EndNote Tanrıverdi HO, Cengiz F, Yakan S, Şenlikçi A, Üstüner MA, İlhan E (March 1, 2013) Laparoskopik total ekstraperitoneal kasık fıtığı tamiri konvansiyonel yönteme tercih edilebilir mi? Randomize klinik çalışma. Journal of Clinical and Experimental Investigations 4 1 80–83.
IEEE H. O. Tanrıverdi, F. Cengiz, S. Yakan, A. Şenlikçi, M. A. Üstüner, and E. İlhan, “Laparoskopik total ekstraperitoneal kasık fıtığı tamiri konvansiyonel yönteme tercih edilebilir mi? Randomize klinik çalışma”, J Clin Exp Invest, vol. 4, no. 1, pp. 80–83, 2013, doi: 10.5799/ahinjs.01.2013.01.0238.
ISNAD Tanrıverdi, Hacı Osman et al. “Laparoskopik Total Ekstraperitoneal kasık fıtığı Tamiri Konvansiyonel yönteme Tercih Edilebilir Mi? Randomize Klinik çalışma”. Journal of Clinical and Experimental Investigations 4/1 (March 2013), 80-83. https://doi.org/10.5799/ahinjs.01.2013.01.0238.
JAMA Tanrıverdi HO, Cengiz F, Yakan S, Şenlikçi A, Üstüner MA, İlhan E. Laparoskopik total ekstraperitoneal kasık fıtığı tamiri konvansiyonel yönteme tercih edilebilir mi? Randomize klinik çalışma. J Clin Exp Invest. 2013;4:80–83.
MLA Tanrıverdi, Hacı Osman et al. “Laparoskopik Total Ekstraperitoneal kasık fıtığı Tamiri Konvansiyonel yönteme Tercih Edilebilir Mi? Randomize Klinik çalışma”. Journal of Clinical and Experimental Investigations, vol. 4, no. 1, 2013, pp. 80-83, doi:10.5799/ahinjs.01.2013.01.0238.
Vancouver Tanrıverdi HO, Cengiz F, Yakan S, Şenlikçi A, Üstüner MA, İlhan E. Laparoskopik total ekstraperitoneal kasık fıtığı tamiri konvansiyonel yönteme tercih edilebilir mi? Randomize klinik çalışma. J Clin Exp Invest. 2013;4(1):80-3.