LE of early rectal cancer is associated with higher local recurrence and decreased DFS. These disadvantages are significant for T2 lesions.

Dysplasia is reliably diagnosed by expert gastrointestinal pathologists but has poor correlation with an endoscopic diagnosis of dysplasia.

Purpose The best approach for simultaneous repair of bilateral inguinal hernia is controversial. The aim of this study is to compare the outcomes after laparoscopic versus open mesh repair of bilateral primary inguinal hernia. Methods this prospective study included 180 patients with bilateral primary inguinal hernia; randomized by sealed envelopes into 3 groups; each includes 60 patients. Group I treated by laparoscopic trans-abdominal pre-peritoneal (TAPP) repair using 2 separate meshes, Group II treated by open pre-peritoneal (PP) single mesh repair, while Group III treated by bilateral Lichtenstein repair. Results In comparison to open PP and bilateral Lichtenstein repair, Laparoscopic TAPP repair had significantly longer operative time and superior early postoperative outcomes including significantly less postoperative pain, hospital stay, time till return to normal activity and to work. Chronic groin pain and mesh sensation was lower in Laparoscopic TAPP group with significantly higher satisfaction rate compared to open groups. No significant difference between study groups in 3 years recurrence rate. Conclusion Simultaneous laparoscopic TAPP repair of uncomplicated primary bilateral inguinal hernia has superior early postoperative outcome, less chronic pain and higher patients' satisfaction rate compared to open approaches with similar low recurrence rate.

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