Short- and Long-Term Outcomes of Transabdominal Preperitoneal, Open Mesh Plug and Open Tissue Inguinal Hernia Repair
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ORIGINAL SCIENTIFIC REPORT
Short- and Long-Term Outcomes of Transabdominal Preperitoneal, Open Mesh Plug and Open Tissue Inguinal Hernia Repair Yuichi Takayama1 • Yuji Kaneoka1 • Atsuyuki Maeda1 • Takamasa Takahashi1 Muneyasu Kiriyama1 • Kazuaki Seita1
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Accepted: 31 October 2020 Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background There have been few comparisons of the postoperative outcomes of transabdominal preperitoneal (TAPP), open mesh plug (mesh plug) and open tissue (tissue) hernia repair. The objectives of this study were to compare these repair methods. Methods This was a retrospective study of 1813 inguinal hernia patients between January 2008 and December 2016. Of these patients, 474 underwent TAPP repair, 1293 underwent mesh plug repair, and 46 underwent tissue repair. The short-term and long-term outcomes determined by questionnaire were compared among the three groups. In addition, risk factors for patient dissatisfaction were assessed. Results In the TAPP group, the postoperative complications rate was the lowest at 4.6% (7.4% and 6.5% in the mesh plug and the tissue groups, respectively, P = 0.07), and recurrence rate was lower compared to the mesh plug group (0.8% vs. 3.3%, P = 0.002). As long-term outcomes, 92%, 88% and 75% of patients were satisfied in the TAPP, mesh plug and tissue groups, respectively (P = 0.03). The rate of patients with numbness was 3.1% in the TAPP group, 5.2% in the mesh plug group and 14% in the tissue group (P = 0.04). Predictive independent risk factors for patient dissatisfaction were complications (OR: 3.99, 95% CI: 1.35–11.8, P = 0.012) and infection (OR: 16.9, 95% CI: 1.25–229, P = 0.003). Conclusions TAPP repair is superior to mesh plug and tissue repairs in terms of complications, satisfaction and numbness, as determined by questionnaire. Complications and infection were independently associated with the patient dissatisfaction.
Introduction Inguinal hernia repair is one of the most common operations performed, and both open and laparoscopic techniques are used [1]. There is ongoing debate regarding the best approach to inguinal hernia repair. The use of prosthetic mesh to create tension-free repair is preferable over non-mesh techniques because of reduced recurrence [2, 3]. & Yuichi Takayama [email protected] 1
Department of Surgery, Ogaki Municipal Hospital, 4-86 minaminokawa-cho, Ogaki-shi, Gifu-ken, Japan
The prosthetic mesh can be placed through either open or laparoscopic surgery. Inguinal hernia patients treated with laparoscopic repair have less postoperative pain and fewer wound infections and return to normal activity and work sooner [4–6]. The most important goal after inguinal hernia repair is to restore function and quality of life (QoL). Several randomized trials have compared laparoscopic, open mesh and non-mesh repair methods. However, in almost all previous reports, mesh repair was performed with the Lichtenstein method [2], and non-mesh repair was performed with the Shouldice or Bassini method [7]. We therefore designed
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