Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial

Konrad Pielaciński; Bartosz Puła; Tadeusz Wróblewski; Michał Kuryłowicz; Andrzej B. Szczepanik

doi:10.5114/wiitm.2019.83611

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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General surgery

abstract:

Randomized controlled trial

Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial

Konrad Pielaciński

¹

,

Bartosz Puła

²

,

Tadeusz Wróblewski

³

,

Michał Kuryłowicz

¹

,

Andrzej B. Szczepanik

¹

Department of General, Oncologic and Metabolic Surgery, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland

Videosurgery Miniinv 2020; 15 (1): 1–10

DOI: https://doi.org/10.5114/wiitm.2019.83611

Online publish date: 2019/03/14

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AMA

Pielaciński K, Puła B, Wróblewski T, Kuryłowicz M, Szczepanik A. Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial. Videosurgery and Other Miniinvasive Techniques. 2020:1-10. doi:10.5114/wiitm.2019.83611.

APA

Pielaciński, K., Puła, B., Wróblewski, T., Kuryłowicz, M.,  & Szczepanik, A. (2020). Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial. Videosurgery and Other Miniinvasive Techniques, 1-10. https://doi.org/10.5114/wiitm.2019.83611

Chicago

Pielaciński, Konrad, Bartosz Puła, Tadeusz Wróblewski, Michał Kuryłowicz,  and Andrzej B. Szczepanik. 2020. "Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial". Videosurgery and Other Miniinvasive Techniques: 1-10. doi:10.5114/wiitm.2019.83611.

Harvard

Pielaciński, K., Puła, B., Wróblewski, T., Kuryłowicz, M.,  and Szczepanik, A. (2020). Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial. Videosurgery and Other Miniinvasive Techniques, pp.1-10. https://doi.org/10.5114/wiitm.2019.83611

MLA

Pielaciński, Konrad et al. "Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial." Videosurgery and Other Miniinvasive Techniques, 2020, pp. 1-10. doi:10.5114/wiitm.2019.83611.

Vancouver

Pielaciński K, Puła B, Wróblewski T, Kuryłowicz M, Szczepanik A. Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial. Videosurgery and Other Miniinvasive Techniques. 2020:1-10. doi:10.5114/wiitm.2019.83611.

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Introduction
The use of implants in inguinal hernia repair has reduced its recurrence rate. However, postoperative groin pain still remains an unresolved problem. There are suggestions that in totally extraperitoneal inguinal hernia repair (TEP-IHR) two of the likely factors responsible for pain are use of fixation and the type of fixation used.

Aim
To evaluate the impact of mesh fixation on the incidence of postoperative pain, restriction of physical activities, hernia recurrence risk, return to normal activities and demand for analgesics in patients after unilateral TEP-IHR.

Material and methods
Unilateral TEP-IHR was performed in 139 male patients randomized to three groups: self-gripping mesh (SG), lightweight mesh (L) and lightweight mesh with fixation (LF). Full study-inclusion criteria were met by 110 patients; 43, 18 and 49 in groups SG, L and LF respectively. Follow-up occurred on the 1st, 2nd, and 7th day and 3, 6, 12 months postoperatively. The numeric rating scale (NRS) was used to assess pain and the EuraHS-QoL (European Registry for Abdominal Wall Hernias Quality of Life Score) questionnaire to compare quality of life (QoL) prior to surgery and one year later.

Results
No statistically significant differences were observed between study groups with regard to the incidence rate and intensity of acute post-operative pain, chronic pain, analgesic demand, return to normal activity, hernia recurrence rate and post-operative QoL.

Conclusions
Lack of fixation in TEP-IHR does not increase the risk of hernia recurrence, and its presence does not significantly worsen the treatment results; especially it does not increase the incidence of chronic pain.

keywords:

Totally extraperitoneal inguinal hernia repair with or without fixation leads to similar results. Outcome of randomized prospective trial

Konrad Pielaciński 1 , Bartosz Puła 2 , Tadeusz Wróblewski 3 , Michał Kuryłowicz 1 , Andrzej B. Szczepanik 1

chronic pain, hernia recurrence, totally extraperitoneal inguinal hernia repair, mesh fixation

Konrad Pielaciński

¹

,

Bartosz Puła

²

,

Tadeusz Wróblewski

³

,

Michał Kuryłowicz

¹

,

Andrzej B. Szczepanik

¹