Prospective, Comparative Study of Postoperative Quality of Life in TEP, TAPP, and Modified Lichtenstein Repairs

Belyansky, Igor; Tsirline, Victor B.; Klima, David A.; Walters, Amanda L.; Lincourt, Amy E.; Heniford, Todd B.

doi:10.1097/sla.0b013e3182359d07

Cited by 125 publications

(112 citation statements)

References 36 publications

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“…9 There is a correlation between chronic pain and fixation of mesh with staples/tacks as compared to fibrin glue and number of tacks, rather than the technique of TEP and TAPP. 6,9 In present study, two (6.6%) patients had chronic pain at 3 months follow-up in TAPP group as compared to the one (3.3%) patients in the TEP group. These results were, however, not statistically significant.…”

Section: Discussionmentioning

confidence: 88%

“…A similar outcome was seen in prospective comparative study of post-operative QOL between TEP and TAPP and open Modified Lichenstein (ML) repair by Belyansky et al, which analyzed the outcome of more than 2000 patients using the Carolina comfort scale. 6 It showed a significant difference during first follow-up month with more symptomatic patients after TAPP as compared to TEP; however, a year after surgery, there remained no difference in discomfort with activities of daily living between patients undergoing TEP, TAPP and open ML repair. 6 This study was, however, not inclusive of Indian population.…”

Section: Discussionmentioning

confidence: 99%

“…6 It showed a significant difference during first follow-up month with more symptomatic patients after TAPP as compared to TEP; however, a year after surgery, there remained no difference in discomfort with activities of daily living between patients undergoing TEP, TAPP and open ML repair. 6 This study was, however, not inclusive of Indian population. A prospective randomized comparative study of quality of life in Indian patients by Bansal et al shows no difference between TEP and TAPP groups in terms of QOL, testicular and sexual functions.…”

Section: Discussionmentioning

confidence: 99%

“…Both techniques are based on the principles of tension free repair and rely on mesh placement in the preperitoneal space to exclude inguinal defect and reinforce the abdominal wall. 6 Both the approaches are well established and have advantages and disadvantages.…”

Section: Introductionmentioning

confidence: 99%

“…7 QOL has become the principal outcome measure of hernia in the face of infrequent overall complications. 6 There are various scales for QOL assessment in hernia patients-Short From-36(SF-36), Visual Analogue Scale (VAS), Carolina Comfort Scale(CCS) and European Registry for Abdominal Wall Hernias-QOL Score (EuraHS-QOL) . SF-36 and VAS are generic QOL scales and can be used for other patients as well.…”

Section: Introductionmentioning

confidence: 99%

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Prospective comparison of post-operative quality of life (QOL) after laparoscopic total extra-peritoneal (TEP) and trans-abdominal pre-peritoneal (TAPP) repair of indirect inguinal hernia

et al. 2018

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Background: As the laparoscopic method is becoming a popular choice of repair, the need to evaluate its impact on the patient’s quality of life (QOL) is also warranted. This study was undertaken to compare post operative QOL in patients undergoing Totally Extraperitoneal (TEP) and Transabdominal preperitoneal (TAPP) repair for indirect inguinal hernia.Methods: This prospective observational study was conducted in the Department of General Surgery at VMMC and Safdarjung Hospital, from June 2016 to March 2018. Patients with uncomplicated indirect inguinal hernia were included in the study after obtaining their informed consent. Post-operative QOL was evaluated using EuraHS-QOL scale at 24 hours and 1, 3 and 6 months after the surgery.Results: A total of sixty patients were enrolled-30 in TEP group and 30 in TAPP group. There was no statistical significant difference in scores at 24 hours follow-up except cosmetic discomfort domain, with higher scores in TAPP (p-value=0.014). Statistical significant difference was present at 1 month follow up with higher scores in TAPP (p-value=0.011). At 3 and 6 months, no statistical difference was found in the scores.Conclusions: Present study demonstrates a significant advantage of TEP over TAPP up to 1-month follow-up, in terms of post-operative QOL. Choosing a superior laparoscopic method between TEP and TAPP requires high powered RCTs with long term follow up to assess the technical advantages and post-operative complications along with post-operative quality of life in patients.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prospective comparison of post-operative quality of life (QOL) after laparoscopic total extra-peritoneal (TEP) and trans-abdominal pre-peritoneal (TAPP) repair of indirect inguinal hernia

et al. 2018

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Shouldice versus Lichtenstein inguinal hernia repair: A meta‐analysis of randomized controlled trials

Pompeu,

Pasqualotto,

Marcolin

et al. 2024

World j. surg.

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BackgroundThe Lichtenstein technique is the standard treatment for adult open inguinal hernia repair. Among the non‐mesh repair techniques, Shouldice has shown the best results and is comparable to mesh repairs in selected cases. Due to the risk of chronic groin pain associated with the Lichtenstein technique, Shouldice has increased in popularity, and some surgeons have adopted it as a viable first‐line option.MethodsMEDLINE, Cochrane, Central Register of Clinical Trials, and EMBASE for randomized controlled trials (RCT) published until February 2024. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random‐effects model. Heterogeneity was assessed using the Cochran Q test and I2 statistics with p‐values <0.10 and I2 > 25% considered significant. Statistical analysis was performed using R Software, version 4.1.2.ResultsFourteen RCTs comprising 2784 patients were included, of whom 1379 (47.5%) were submitted to the Shouldice hernia repair and 1513 (52.5%) to the Lichtenstein technique. Shouldice was associated with a significant increase in the recurrence rate (4.2% vs. 0.9%; RR 3.68; 95% CI 2.05–6.60; p < 0.001; I2 = 0%) compared with Lichtenstein. The number needed to treat (NNT) to prevent one Shouldice recurrence was 30.3. There were no significant differences between groups in chronic pain, urinary retention, bladder injury, testicular atrophy, wound infection, hematoma–seroma, or hypesthesia.ConclusionThe Lichtenstein technique was associated with reduced recurrence rates compared with Shouldice in patients undergoing inguinal hernia repair. However, the overall recurrence rate with the Shouldice technique was still low (4.2%), suggesting that it may be a viable option in selected patients.

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TAPP vs. TEP

Carbonell

2012

The SAGES Manual of Hernia Repair

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Prospective, Comparative Study of Postoperative Quality of Life in TEP, TAPP, and Modified Lichtenstein Repairs

Abstract: Use of >10 tacks doubles the incidence of early postoperative pain while having no effect on rates of recurrence. There was no difference in chronic postoperative pain comparing ML, TEP, and TAPP including when controlled for tack use.

Cited by 125 publications

References 36 publications

Prospective comparison of post-operative quality of life (QOL) after laparoscopic total extra-peritoneal (TEP) and trans-abdominal pre-peritoneal (TAPP) repair of indirect inguinal hernia

Prospective comparison of post-operative quality of life (QOL) after laparoscopic total extra-peritoneal (TEP) and trans-abdominal pre-peritoneal (TAPP) repair of indirect inguinal hernia

Shouldice versus Lichtenstein inguinal hernia repair: A meta‐analysis of randomized controlled trials

TAPP vs. TEP

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