A Comparative Outcome Analysis of Bilateral versus Unilateral Endoscopic Extraperitoneal Inguinal Hernioplastics

Lau, Hung; Patil, NG; Yuen, WK

doi:10.1089/109264203766207663

Cited by 17 publications

(24 citation statements)

References 11 publications

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“…In this study the incidence of OCH was 26% (13/50), and left-sided hernias were 17.5% more likely to have an OCH than were rightsided hernias. This seems to be consistent with existing literature regarding the higher incidence of OCH on the opposite side in left-sided hernias [18]. The reason postulated for the higher incidence of OCH on the right in hernias of the left side could be attributed to embryological development of the processus vaginalis by which the left processus is the one that obliterates first.…”

Section: Discussionsupporting

confidence: 92%

“…Among the 13 contralateral cases (OCH), 6/16 were on the right side in left-sided hernias and 7/34 were on the left in right-sided hernias. The incidence of OCH in our study falls well within the previously reported incidence of OCH [9,15,16,18]. However no comparison was made in previous studies with respect to operative time and the incidence of complications in true unilateral cases versus those in which a contralateral OCH was discovered.…”

Section: Discussionsupporting

confidence: 85%

“…Another similar study of 103 patients also emphasized similar morbidity and complication rates following bilateral hernia repairs with TEP as compared with unilateral laparoscopic TEP [18].…”

Section: Discussionmentioning

confidence: 81%

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Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair

et al. 2010

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In the present study bilateral TEP was performed in three types of patients: those with clinically bilateral hernias, those with clinically unilateral hernia but with an OCH, and in truly unilateral hernias. All of these were compared with unilateral TEPs in clinically unilateral hernias, and we found no significant increase in morbidity, pain, recurrence or complications in bilateral repairs. Convalescence from surgery, as determined by return to activities of daily living and return to work parameters, was also comparable. Surgeons experienced in laparoscopic TEP, in high-volume centers, can provide bilateral repairs in patients with inguinal hernia, bearing in mind its advantages and comparable morbidity. We also feel that, in elective repair of inguinal hernia, the patient should be given the option of bilateral repair. Bilateral repair does not add to the risk of surgery in experienced hands and we strongly feel that unilateral TEP is actually a job half done.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 85%

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Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair

et al. 2010

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“…The duration of surgery in the study of Lau et al [18] (unilateral, 64 min vs. bilateral, 97 min) was comparable with that in our study. The recovery time, mean LOS (unilateral, 1.5 days vs. bilateral, 1.7 days), and incidence of postoperative general complications and postoperative surgical complications did not differ significantly between the two groups.…”

Section: Discussionsupporting

confidence: 90%

“…These data correspond to findings from a much smaller study reported by Lau et al [18], in which 103 patients undergoing bilateral TEP for inguinal hernia were prospectively investigated during 3 years and compared with an age-matched cohort of patients who underwent unilateral TEP during the same period. The duration of surgery in the study of Lau et al [18] (unilateral, 64 min vs. bilateral, 97 min) was comparable with that in our study.…”

Section: Discussionsupporting

confidence: 87%

Bilateral total extraperitoneal inguinal hernia repair (TEP) has outcomes similar to those for unilateral TEP: population-based analysis of prospective data of 6,505 patients

et al. 2011

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Background Whether bilateral total extraperitoneal (TEP) inguinal hernia repair is associated with worse outcomes than unilateral TEP continues to be a matter of debate. This study aimed to compare different outcomes of large cohorts of patients undergoing bilateral versus unilateral TEP. Methods Based on prospective data of the Swiss Association of Laparoscopic and Thoracoscopic Surgery (SALTS), all patients undergoing elective unilateral or bilateral TEP from 1995 to 2006 were included in the study. The outcomes compared included conversion rates; intraoperative, surgical, and general postoperative complications; duration of operation; and length of hospital stay (LOS). Unadjusted and risk-adjusted multivariable analyses were performed. Results Data for 6,505 patients undergoing unilateral (n = 3,457) and bilateral (n = 3,048) TEP were prospectively collected. The average age and the American Society of Anesthesiologists (ASA) score were similar in the two groups. The patients undergoing bilateral TEP repair had a slightly increased rate of intraoperative complications (bilateral, 3.1% vs. unilateral, 1.9%) and surgical postoperative complications (bilateral, 3.2% vs. unilateral, 2.3%). The operation time was longer for bilateral TEP repair (86 vs. 67 min). No significant differences in postoperative LOS, general postoperative complications, or conversion rates were found. Conclusions This is the first population-based analysis in the literature to compare different outcomes in a prospective cohort of more than 6,500 patients undergoing bilateral versus unilateral TEP. Although the rates for intraoperative and surgical postoperative complications were slightly higher for the patients undergoing bilateral TEP repair, the absolute differences were small and of minor clinical relevance. Bilateral TEP repair is associated with a minimal increase in operating time and similar LOS, general postoperative complications, and conversion rates. Therefore, for patients with bilateral inguinal hernia, a simultaneous endoscopic approach represents an excellent therapeutic option.Keywords Bilateral vs. unilateral inguinal hernia repair Á Inguinal hernia Á Population-based analysis Á TEP Á Total extraperitoneal inguinal hernia repair Symptomatic inguinal hernia is a common surgical problem, and inguinal hernia repair is among the most frequently performed operations in general surgery [1,2]. Indeed, more than 800,000 groin hernia repairs are performed in the United States each year [3]. Approximately 15% of all inguinal hernias are bilateral [4]. The debate continues as to whether bilateral hernias should be repaired simultaneously or sequentially [5,6].

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Convalescence after laparoscopic inguinal hernia repair: a qualitative systematic review

2016

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A Comparative Outcome Analysis of Bilateral versus Unilateral Endoscopic Extraperitoneal Inguinal Hernioplastics

Abstract: The postoperative recovery and morbidity of patients who underwent bilateral TEP were equivalent to those who underwent unilateral TEP. Simultaneous bilateral TEP is safe and advantageous in patients with from bilateral inguinal hernias.

Cited by 17 publications

References 11 publications

Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair

Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair

Bilateral total extraperitoneal inguinal hernia repair (TEP) has outcomes similar to those for unilateral TEP: population-based analysis of prospective data of 6,505 patients

Convalescence after laparoscopic inguinal hernia repair: a qualitative systematic review

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