Early assessment of bilateral inguinal hernia repair: A comparison between the laparoscopic total extraperitoneal and Stoppa approaches

Abstract

BACKGROUND:The present clinical trial was designed to compare the results of bilateral inguinal hernia repair between patients who underwent the conventional Stoppa technique and laparoscopic total extraperitoneal repair (LTE) with a single mesh and without staple fixation.PATIENTS AND METHODS:This controlled, randomised clinical trial was conducted at General Surgery and Trauma of the Clinics Hospital, Medical School, the University of São Paulo between September 2010 and February 2011. Totally, 50 male patients, with a bilateral inguinal hernia, older than 25 years were considered eligible for the study. The following parameters were analysed during the early post-operative period: (1) The intensity of surgical trauma, operation time, C-reactive protein (CRP) levels, white blood cell count, bleeding and pain intensity; (2) quality of life assessment; and (3) post-operative complications.RESULTS:LTE procedure was longer than the Stoppa procedure (134.6 min ± 38.3 vs. 90.6 min ± 41.3; P < 0.05). The levels of CRP were higher in the Stoppa group (P < 0.05) but the number of leucocytes, haematocrit, and haemoglobin were similar between the groups (P > 0.05). There was no difference in pain during the 1st and 7th post-operative, physical functioning, physical limitation, the impact of pain on daily activities, and the Carolinas Comfort Scale during the 7th and 15th post-operative (P > 0.05). Complications occurred in 88% of Stoppa group (22 patients) and 64% in LTE group (16 patients) (P < 0.05).CONCLUSION:The comparative study between the Stoppa and LTE approaches for the bilateral inguinal hernia repair demonstrated that: (1) The LTE approach showed less surgical trauma despite the longer operation time; (2) Quality of life during the early post-operative period were similar; and (3) Complication rates were higher in the Stoppa group.

Serum Selenium Concentration as a Potential Diagnostic Marker for Early-Stage Colorectal Cancer: A Comparative Study

“…The sample size of the examined group of patients was used as the average sample size. The sample size of the comparison group was higher than that used by Shehata et al [ 51 ] and Utiyam et al [ 52 ] but lower than that in other related studies [ 53 , 54 ]. However, the total number of patients in CRC-related studies [ 54 – 58 ] was higher than the number of patients examined in the aforementioned studies, and the patient number ranged from 50 [ 59 ] to 150 patients [ 60 ].…”

Open Lichtenstein Hernioplasty Versus Laparoscopic Transabdominal Preperitoneal Mesh Repair: The Pain Factor

“…Scheuermann et al [ 5 ] in their meta-analysis found that the operative time is longer in laparoscopic TAPP as compared to open surgery. Utiyama et al [ 6 ] on the other hand found no significant difference. Studies have demonstrated that with specialization and experience, the operative time becomes clinically irrelevant [ 5 , 7 ].…”