Takaaki Tsushimi, Kazuhito Oka. Yamaguchi-ken Saiseikai Shimonoseki General Hospital
Introduction: Tension-free anterior open (AO) repair, using mesh and/or a plug, is a popular surgical choice for inguinal hernia. Laparoscopic transabdominal preperitoneal repair (TAPP) is gradually increasing, however, TAPP is considered more invasive than AO repair. In general, the TAPP procedure has been considered to take longer and have a higher rate of post-operative complications. The purpose of this study was to compare the TAPP and AO procedures to determine if there is a significant difference in safety outcomes or in the practicability of the procedures themselves.
Methods and Procedures: A total of 104 patients with inguinal hernia were included in this study, of which 51 underwent TAPP and 53 underwent AO repair from April 2015 to August 2016 at Yamaguchi-ken Saiseikai Shimonoseki General Hospital. Patient characteristics (age, sex), surgery-related factors (hernia type, affected side, operation time), and postoperative factors (WBC or CRP values on Day 1 or Day 3 post-procedure, and post-surgical complications) were retrospectively analyzed and compared between the two groups.
Results: There were no significant differences in age, sex, hernia type, or affected side between the two groups. There were also no significant differences in the mean length of time required for the procedure (TAPP: 61.3 ± 16.7 minutes, AO: 60.1 ± 20.1 minutes). On Days 1 and 3 post-procedure, mean WBC values were 7749 ± 2023 /μl and 6397 ± 1787 /μl, respectively, in the TAPP group and 8174 ± 1949 /μl and 6340 ± 1531 /μl, respectively, in the AO group. No significant differences were observed. The mean Day 1 and Day 3 post-procedure CRP measurements were 1.12 ± 0.81 mg/dl and 2.46 ± 3.40 mg/dl, respectively, in the TAPP group and 2.22 ± 1.88 mg/dl and 3.88 ± 3.40 mg/dl, respectively, in the AO group. The mean Day 1 post-procedure CRP value was significantly lower in the TAPP group (p<0.01). No significant differences between the two groups were observed for mean length of post-operative stay (TAPP: 3.1 ± 1.1 days, AO: 3.4 ± 1.0 days) or for the rates of post-operative complications (TAPP: 6 [5 seroma, 1 wound infection]; AO: 6 [1 chronic pain, 1 recurrence, 2 seroma, 2 subcutaneous hematoma]).
Conclusions: Based on a retrospective evaluation of several key parameters, no significant differences were observed between the TAPP and AO procedures that would indicate that TAPP is a safe and feasible operation and it is also comparable in surgical stress to AO repair.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77290
Program Number: P022
Presentation Session: Poster (Non CME)
Presentation Type: Poster