Low Recurrence Rate After Laparoscopic (TEP) and Open (Lichtenstein) Inguinal Hernia Repair A Randomized, Multicenter Trial With 5-Year Follow-Up

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Low Recurrence Rate After Laparoscopic (TEP) and Open (Lichtenstein) Inguinal Hernia Repair A Randomized, Multicenter Trial With 5-Year Follow-Up. / Eklund, Arne S.; Montgomery, Agneta; Rasmussen, Ib C.; Sandbue, Rune P.; Bergkvist, Leif A.; Rudberg, Clues R.

In: Annals of Surgery, Vol. 249, No. 1, 2009, p. 33-38.

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Eklund, Arne S. ; Montgomery, Agneta ; Rasmussen, Ib C. ; Sandbue, Rune P. ; Bergkvist, Leif A. ; Rudberg, Clues R. / Low Recurrence Rate After Laparoscopic (TEP) and Open (Lichtenstein) Inguinal Hernia Repair A Randomized, Multicenter Trial With 5-Year Follow-Up. In: Annals of Surgery. 2009 ; Vol. 249, No. 1. pp. 33-38.

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TY - JOUR

T1 - Low Recurrence Rate After Laparoscopic (TEP) and Open (Lichtenstein) Inguinal Hernia Repair A Randomized, Multicenter Trial With 5-Year Follow-Up

AU - Eklund, Arne S.

AU - Montgomery, Agneta

AU - Rasmussen, Ib C.

AU - Sandbue, Rune P.

AU - Bergkvist, Leif A.

AU - Rudberg, Clues R.

PY - 2009

Y1 - 2009

N2 - Objectives: To compare a laparoscopic (totally extraperitoneal patch (TEP)) and an open technique (Lichtenstein) for inguinal hernia repair regarding recurrence rate and possible risk factors for recurrence. Summary Background Data: Laparoscopic hernia repair has been introduced as an alternative to open repair. Short-term follow-tip suggests benefits for those patients operated with a laparoscopic approach compared with open techniques; ie, less postoperative pain and a shorter convalescence period. Long-term results, however, arc less well known. Methods: The study was conducted as a Multicenter randomized trial with a 5-year follow-up. A total of 1512 men aged 30 to 70 years, with a primary unilateral inguinal hernia, were randomized to either TEP or Lichtenstein repair. Results: Overall, 665 patients in the TEP group and 705 patients in the Lichtenstein group were evaluable. The cumulative recurrence rate was 3.5% in the TEP group and 1.2% in the Lichtenstein group (P = 0.0081). Test For heterogeneity revealed significant differences between individual Surgeons. The exclusion of 1 surgeon, who was responsible for 33% (7 of 21) of all recurrences in the TEP group, lowered the cumulative recurrence rate to 2.4% in this group, which was not statistically different front that of the Lichtenstein group. Conclusions: The recurrence rate for both TEP and Lichtenstein repair was low. A higher cumulative recurrence rate in the TEP group was seen at 5 years. Further analysis revealed that this could be attributable to incorrect surgical technique.

AB - Objectives: To compare a laparoscopic (totally extraperitoneal patch (TEP)) and an open technique (Lichtenstein) for inguinal hernia repair regarding recurrence rate and possible risk factors for recurrence. Summary Background Data: Laparoscopic hernia repair has been introduced as an alternative to open repair. Short-term follow-tip suggests benefits for those patients operated with a laparoscopic approach compared with open techniques; ie, less postoperative pain and a shorter convalescence period. Long-term results, however, arc less well known. Methods: The study was conducted as a Multicenter randomized trial with a 5-year follow-up. A total of 1512 men aged 30 to 70 years, with a primary unilateral inguinal hernia, were randomized to either TEP or Lichtenstein repair. Results: Overall, 665 patients in the TEP group and 705 patients in the Lichtenstein group were evaluable. The cumulative recurrence rate was 3.5% in the TEP group and 1.2% in the Lichtenstein group (P = 0.0081). Test For heterogeneity revealed significant differences between individual Surgeons. The exclusion of 1 surgeon, who was responsible for 33% (7 of 21) of all recurrences in the TEP group, lowered the cumulative recurrence rate to 2.4% in this group, which was not statistically different front that of the Lichtenstein group. Conclusions: The recurrence rate for both TEP and Lichtenstein repair was low. A higher cumulative recurrence rate in the TEP group was seen at 5 years. Further analysis revealed that this could be attributable to incorrect surgical technique.

U2 - 10.1097/SLA.0b013e31819255d0

DO - 10.1097/SLA.0b013e31819255d0

M3 - Article

C2 - 19106673

VL - 249

SP - 33

EP - 38

JO - Annals of Surgery

JF - Annals of Surgery

SN - 1528-1140

IS - 1

ER -