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Surgical Endoscopy
Published in: Surgical Endoscopy 8/2017

Open Access 01-08-2017

Laparo-endoscopic versus open recurrent inguinal hernia repair: should we follow the guidelines?

Authors: F. Köckerling, R. Bittner, A. Kuthe, B. Stechemesser, R. Lorenz, A. Koch, W. Reinpold, H. Niebuhr, M. Hukauf, C. Schug-Pass

Published in: Surgical Endoscopy | Issue 8/2017

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Abstract

Introduction

On the basis of six meta-analyses, the guidelines of the European Hernia Society (EHS) recommend laparo-endoscopic recurrent repair following previous open inguinal hernia operation and, likewise, open repair following previous laparo-endoscopic operation. So far no data are available on implementation of the guidelines or for comparison of outcomes. Besides, there are no studies for comparison of outcomes for compliance versus non-compliance with the guidelines.

Patients and methods

In total, 4812 patients with elective unilateral recurrent inguinal hernia repair in men were enrolled between September 1, 2009, and September 17, 2014, in the Herniamed Registry. Only patients with 1-year follow-up were included.

Results

Out of the 2482 laparo-endoscopic recurrent repair operations 90.5% of patients, and out of the 2330 open recurrent repair procedures only 38.5% of patients, were operated on in accordance with the guidelines of the EHS. Besides, on compliance with the guidelines multivariable analysis demonstrated for laparo-endoscopic recurrent repair a significantly lower risk of pain at rest (OR 0.643 [0.476; 0.868]; p = 0.004) and pain on exertion (OR 0.679 [0.537; 0.857]; p = 0.001). Comparison of laparo-endoscopic and open recurrent repair in settings of compliance versus non-compliance with the guidelines showed a higher incidence of perioperative complications and re-recurrences for recurrent repairs that did not comply with the guidelines.

Conclusion

The EHS guidelines for recurrent inguinal hernia repair are not yet being observed to the extent required. Non-compliance with the guidelines is associated with higher perioperative complication rates and higher risk of re-recurrence. Even on compliance with the guidelines, the risk of pain at rest and pain on exertion is higher after open recurrent repair than after laparo-endoscopic repair.
Literature
1.
Köckerling F, Jacob D, Wiegank W, Hukauf M, Schug-Pass C, Kuthe A, Bittner R (2016) Endoscopic repair of primary versus recurrent male unilateral inguinal hernias: are there differences in the outcome? Surg Endosc 30:1146–1155. doi:10.​1007/​s00464-015-4318-3 CrossRefPubMed
2.
Köckerling F, Koch A, Lorenz R, Reinpold W, Hukauf M, Schug-Pass C (2016) open repair of primary versus recurrent male unilateral inguinal hernias: perioperative complications and 1-year follow-up. World J Surg 40:813–825. doi:10.​1007/​s00268-015-3325-9 CrossRefPubMed
3.
Karthikesalingam A, Markar SR, Holt PJE, Praseedom RK (2010) Meta-analysis of randomized controlled trials comparing laparoscopic with open mesh recurrent inguinal hernia repair. Br J Surg 97:4–11. doi:10.​1002/​bjs.​6902 CrossRefPubMed
4.
5.
Yang J, Tong DN, Yao J, Chen W (2013) Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: a meta-analysis of randomized controlled trials. ANZ J. Surg. 83:312–318. doi:10.​1111/​ans.​12010 CrossRefPubMed
6.
Pisanu A, Podda M, Saba A, Porceddu G, Uccheddu A (2015) Meta-analysis and review of prospective randomized trials comparing laparoscopic and Lichtenstein techniques in recurrent inguinal hernia repair. Hernia 19:355–366. doi:10.​1007/​s10029-014-1281-1 CrossRefPubMed
7.
8.
Miserez M, Peeters E, Aufenacker T, Bouillot JL, Campanelli G, Conze J, Fortelny R, Heikkinen T, Jorgensen LN, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Simons MP (2014) Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 18:151–163. doi:10.​1007/​s10029-014-1236-6 CrossRefPubMed
9.
Kumar S, Nixon SL, MacIntyre IM (1999) Laparoscopic or Lichtenstein repair for recurrent inguinal hernia: one unit’s experience. J R Coll Surg Edinb 44:301–302PubMed
10.
Beets GL, Dirksen CD, Go PM, Geisler FE, Baeten CG, Kootstra G (1999) Open or laparoscopic preperitoneal mesh repair for recurrent inguinal hernia? A randomized controlled trial. Surg Endosc 13:323–327CrossRefPubMed
11.
Neumayer L, Giobbie-Hurder A, Jonasson O, Fitzgibbons R Jr, Dunlop D, Gibbs J, Reda D, Henderson W, Veterans Affairs Cooperative Studies Program 456 (2004) Open mesh versus laparoscopic mesh repair of inguinal hernia. N Engl J Med 350:1819–1827CrossRefPubMed
12.
Feliu X, Torres G, Viňas X, Martinez-Ródenas F, Fernández-Sallent E, Pie J (2004) Preperitoneal repair for recurrent inguinal hernia: laparoscopic and open approach. Hernia 8:113–116CrossRefPubMed
13.
Richards SK, Vipond MN, Earnshaw JJ (2004) Review of the management of recurrent inguinal hernia. Hernia 8:144–148CrossRefPubMed
14.
Rahr HB, Bendix J, Ahlburg P, Gjedsted J, Funch-Jensen P, Tønnesen E (2006) Coagulation, inflammatory, and stress responses in a randomized comparison of open and laparoscopic recurrent inguinal hernia repair. Surg Endosc 20:468–472CrossRefPubMed
15.
Dedemadi G, Sgourakis G, Karaliotas C, Christofides T, Kouraklis G, Karaliotas C (2006) Comparison of laparoscopic and open tension-free recurrent inguinal hernia repairs: a prospective randomized study. Surg Endosc 20:1099–1104CrossRefPubMed
16.
Alani A, Duffy F, O’Dwyer PJ (2006) Laparoscopic or open preperitoneal repair in the management of recurrent groin hernias. Hernia 10:156–158CrossRefPubMed
17.
Eklund A, Rudberg C, Leijonmarck CE, Rasmussen I, Spangen L, Wickbom G, Wingren U, Montgomery A (2007) Recurrent inguinal hernia: randomized multicenter trial comparing laparoscopic and Lichtenstein repair. Surg Endosc 21:634–640CrossRefPubMed
18.
Kouhia ST, Huttunen R, Silvasti SO, Heiskanen JT, Ahtola H, Uotila-Nieminen M, Kiviniemi VV, Hakala T (2009) Lichtenstein hernioplasty versus totally extraperitoneal laparoscopic hernioplasty in treatment of recurrent inguinal hernia: a prospective randomized trial. Ann Surg 249:384–387. doi:10.​1097/​SLA.​0b013e318196d0b0​ CrossRefPubMed
19.
Shah NR, Mikami DJ, Cook C, Manilchuk A, Hodges C, Memark VR, Volckmann ET, Hall CR, Steinberg S, Needleman B, Hazey JW, Melvin WS, Narula VK (2011) A comparison of outcomes between open and laparoscopic surgical repair of recurrent inguinal hernias. Surg Endosc 25:2330–2337. doi:10.​1007/​300464-010-1564-2 CrossRefPubMed
20.
Demetrashvili Z, Qerqadze V, Kamkamidze G, Topchishvili G, Lagvilava L, Chartholani T, Archvadze V (2011) Comparison of Lichtenstein and laparoscopic transabdominal preperitoneal repair of recurrent inguinal hernias. Int Surg 96:233–238CrossRefPubMed
21.
Saber A, Hokkam EN, Ellabban GM (2015) Laparoscopic transabdominal preperitoneal approach for recurrent inguinal hernia: a randomized trial. J. Minim. Access. Surg. 11:123–128CrossRefPubMedPubMedCentral
22.
Sevonius D, Montgomery A, Smedberg S, Sandblom G (2016) Chronic groin pain, discomfort and physical disability after recurrent groin hernia repair: impact of anterior and posterior mesh repair. Hernia 20:43–53. doi:10.​1007/​s10029-015-1439-5 CrossRefPubMed
23.
Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13:343–403. doi:10.​1007/​s10029-009-0529-7 CrossRefPubMedPubMedCentral
24.
Bittner R, Arregui ME, Bisgaard T, Dudai M, Ferzli GS, Fitzbibbons RJ, Fortelny RH, Klinge U, Köckerling F, Kuhry E, Kukleta J, Lomanto D, Misra MC, Montgomery A, Morales-Conde S, Reinpold W, Rosenberg J, Sauerland S, Schug-Paß C, Singh K, Timoney M, Weyhe D, Chowbey P (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal Hernia [International Endohernia Society (IEHS)]. Surg Endosc 25:2773–2843. doi:10.​1007/​s00464-011-1799-6 CrossRefPubMedPubMedCentral
25.
Bittner R, Montgomery MA, Arregui E, Bansal V, Bingener J, Bisgaard T, Buhck H, Duai M, Ferzli GS, Fitzgibbons RL, Fortelny RH, Grimes KL, Klinge U, Köckerling F, Kumar S, Kukleta J, Lomanto D, Misra MC, Morales-Conde S, Reinpold W, Rosenberg J, Singh K, Timoney M, Weyhe D, Cowbey P, International Endohernia Society (2015) Update of guidelines on laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia (International Endohernia Society). Surg Endosc 29:289–321. doi:10.​1007/​s00464-014-3917-8 CrossRefPubMed
26.
Poelman MM, van den Heuvel B, Deelder JD, Abis GSA, Beudeker N, Bittner R, Campanelli G, van Dam D, Dwars BJ, Eker HH, Fingerhut A, Khatkov I, Koeckerling F, Kukleta JF, Miserez M, Montgomery A, Munoz Brands RM, Morales-Conde S, Muysoms FE, Soltes M, Tromp W, Yavuz Y, Bonjer HJ (2013) EAES consensus development conference on endoscopic repair of groin hernias. Surg Endosc 27:3505–3519. doi:10.​1007/​s00464-013-3001-9 CrossRefPubMed
27.
28.
Richards SK, Earnshaw JJ (2003) Management of primary and recurrent inguinal hernia by surgeons from the South West of England. Ann R Coll Surg Engl 85:402–404CrossRefPubMedPubMedCentral
29.
30.
Miserez M, Alexandre JH, Campanelli G, Corcione F, Cuccurullo D, Pascual MH, Hoeferlin A, Kingsnorth AN, Mandala V, Palot JP, Schumpelick V, Simmermacher RK, Stoppa R, Flament JB (2007) The European hernia society groin hernia classification: simple and easy to remember. Hernia 11:113–116CrossRefPubMed
31.
Metadata
Title
Laparo-endoscopic versus open recurrent inguinal hernia repair: should we follow the guidelines?
Authors
F. Köckerling
R. Bittner
A. Kuthe
B. Stechemesser
R. Lorenz
A. Koch
W. Reinpold
H. Niebuhr
M. Hukauf
C. Schug-Pass
Publication date
01-08-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 8/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5342-7

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