Transabdominal Preperitoneal (tapp) Vs Lichtenstein Primary Hernia Repair: Long-term Results

Background: The surgical preference for inguinal hernia repair is still under debate and discussed controversial. Short- and long-term results are based on data of different surgical trials with diverse results. In this retrospective study the long-term results of the transabdominal preperitoneal (TAPP) hernia repair and the Lichtenstein technique were compared.
Method: Between 2000 and 2005, the TAPP or the Lichtenstein primary inguinal hernia repair was performed in patients that were examined and analyzed retrospectively. The TAPP repair was performed at a single centre and the Lichtenstein approach at another centre. Patients data, the clinical course, complications and the recurrence rate were recorded. Quality of life was analyzed using the GIQLI and the SF-36 questionnaire.
Results: A total of 286 patients were retrospectively analyzed after the TAPP (Group I) or Lichtenstein (Group II) primary hernia repair. Group I were 196 patients with a mean age of 42.5 years (range, 14-74 years) and Group II were 90 patients with a mean age of 63.4 years (range, 25-93 years). According to the ASA classification most patients in Group I were ASA I and in Group II ASA II. Mean hospitalization for Group I patients was 3.2 days (range, 2-9 days) and for Group II 3.4 days (range, 1-8 days). None of the patients had intra-operatively complications or an organ injury. Complication rate was 4.1% for Group I and 10.0% for Group II. Recurrence rate for the TAPP group was 11.1% and the Lichtenstein repair group 6.5%. Mean general score of the GIQLI questionnaire in Group I was superior to the normal population, but lower in Group II. For the SF-36, higher scores were obtained in both groups for the items vitality, body pain and general health compared to the normal population.
Conclusions: The Lichtenstein procedure was more effective regarding the recurrence rate. The TAPP repair was superior to the Lichtenstein technique concerning the complication rate and the quality of life.

Session: Podium Presentation

Program Number: S041

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