Comparative Outcomes of Laparoscopic Total Extraperitoneal Hernia Repair Versus Open Lichtenstein Hernia Repair: Priest Hospital’s Experiences
Keywords:
Inguinal hernia, laparoscopic total extraperitoneal hernia repair, LichtensteinAbstract
Background: Laparoscopic repair of inguinal hernia is increasingly performed. Many studies demonstrated that laparoscopic repair had benefits of less postoperative pain, faster recovery and no difference in complications and recurrence rate. Priest Hospital, with its unique patients’ characteristics and hospital policy, has never studied the outcomes of this surgery.
Objective: To compare laparoscopic total extraperitoneal hernia repair (TEP) with Lichtenstein hernia repair (LT).
Patients and Methods: From June 2012 - June 2015, 275 patients underwent elective inguinal hernia repair at Priest Hospital. A retrospective review of demographic data, operative outcomes and complications were analyzed.
Results: There were 116 patients in LT group and 117 patients in TEP group (42 patients were excluded from the study). This study demonstrated significantly less postoperative pain score in TEP group at 4 hrs. (p < 0.001) and 24 hrs. (p = 0.043) after surgery but not significantly different at 48 hrs. (p = 0.094). The patients in LT group significantly needed more intravenous opioid drugs (p <0.001). The operative time was longer in TEP (p < 0.001) while the length of stay was shorter in TEP (p <0.001). For postoperative pain at 1 week and 1 month of follow up, there were more patients with pain in LT group (p < 0.001 and p = 0.017, respectively) but not significantly different in terms of chronic pain (p = 0.983), numbness (p = 0.079) and recurrence rate (p =0.369). Overall complications were not different (p = 0.296).
Conclusion: TEP had advantage of less postoperative pain, faster recovery, shorter hospital stay but had longer operative time. It can be done safely with no difference in complication and recurrence rate.
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