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01-08-2020 | Inguinal Hernia | Original Article

Re-recurrence and pain 12 years after laparoscopic transabdominal preperitoneal (TAPP) or Lichtenstein’s repair for a recurrent inguinal hernia: a multi-centre single-blinded randomised clinical trial

Authors: L. Lydeking, N. Johansen, J. Oehlenschläger, M. Bay-Nielsen, T. Bisgaard

Published in: Hernia | Issue 4/2020

Abstract

Background

Long-term clinical outcome after a recurrent inguinal hernia repair may be associated with the type of repair, that is, laparoscopic or open. The results from previous randomised controlled trials are inconclusive regarding the long-term risk of re-recurrence chronic pain. Accordingly, this trial compared laparoscopic transabdominal preperitoneal repair (TAPP) with Lichtenstein’s repair. The primary outcome was repair for a re-recurrence. The secondary outcome was chronic pain.

Methods

Multi-centre single-blinded, randomised trial on TAPP vs Lichtenstein’s repair in male patients operated for a recurrent inguinal hernia after a primary open inguinal hernia repair. Follow-up for repair for a re-recurrence was registered in the Danish Hernia Database. Prospective follow-up data were achieved by a structured questionnaire on pain-related functional impairment using the Activities Assessment Scale (AAS-pain).

Result

A total of 360 patients were randomised, 297 were mailed the follow-up questionnaire (63 excluded) after median 12 years (range 9–15). A total of 265 patients responded to the questionnaire (response rate 89%). The cumulative rate of repair for re-recurrence after 12 years was 10% (95% confidence interval (CI) 5.3–15.1%) vs 10% (5.6–14.7%) after TAPP or Lichtenstein, respectively (p = 0.764). Moderate/severe AAS-pain was reported by 4% (95% CI 1–8%) vs 7% (95% CI 3–11%) patients after TAPP or Lichtenstein, respectively (p = 0.698)

Conclusion

Long-term re-recurrence rate and incidence of chronic pain was surprisingly high respectless of surgical approach and neither TAPP nor Lichtenstein’s procedure was superior to improve surgical results.

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Title: Re-recurrence and pain 12 years after laparoscopic transabdominal preperitoneal (TAPP) or Lichtenstein’s repair for a recurrent inguinal hernia: a multi-centre single-blinded randomised clinical trial
Authors: L. Lydeking
N. Johansen
J. Oehlenschläger
M. Bay-Nielsen
T. Bisgaard
Publication date: 01-08-2020
Publisher: Springer Paris
Keyword: Inguinal Hernia
Published in: Hernia / Issue 4/2020
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-020-02139-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Re-recurrence and pain 12 years after laparoscopic transabdominal preperitoneal (TAPP) or Lichtenstein’s repair for a recurrent inguinal hernia: a multi-centre single-blinded randomised clinical trial

Abstract

Background

Methods

Result

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Result

Conclusion

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