Patient’s satisfaction at 2 years after groin hernia repair: any difference according to the technique?
Long-term patient’s satisfaction after groin hernia repair is rarely studied in the literature. The aim of this study was to compare the four main techniques of inguinal hernia repair in terms of patient‘s satisfaction and quality of life at the 2-year follow-up in a prospective registry.
From September 2011 to March 2014, consecutive patients underwent groin hernia repair and were prospectively included in the Club Hernie registry, which also consisted of expert surgeons in parietal repair. The data on patient demographics, clinical presentation, initial workup, operative technique, postoperative course, clinical follow-up, and quality of life at 2 years (2Y-FU) were recorded.
Overall, 5670 patients were included in the study: 1092 undergoing Lichtenstein’s technique, 1259 for trans-inguinal preperitoneal technique (TIPP), 1414 for totally extraperitoneal approach (TEP) and 1905 for transabdominal preperitoneal approach (TAPP). The patients undergoing Lichtenstein’s technique were significantly older, with more inguinoscrotal hernias and co-morbidities than those undergoing other techniques. A total of 83% patients had a complete 2Y-FU. The patient’s satisfaction at 2Y-FU was similar between the different techniques. In the univariate and multivariate analyses, pain on postoperative day 1 was the only independent prognostic factor of the patient’s satisfaction at 2Y-FU.
In this large series, no statistical differences were found between the four studied techniques regarding the 2Y-Fu results and patients’ satisfaction. Provided the technique has been done properly (expert surgeon) the results and the patients’ satisfaction are fair and equivalent among the four studied techniques. In a multivariate analysis, the only factor predictive of bad late results was severe pain at D1.
KeywordsQuality of life Inguinal hernia repair TIPP Lichtenstein TEP TAPP Registry
The Club Hernie group: J-F. Ain: Polyclinique Val de Saone, Macon, France, M. Beck: Clinique Ambroise Paré, Thionville, France, C. Barrat: Hôpital Universitaire Jean Verdier, Bondy, France, C. Berney: Bankstown-Lidcombe Hospital, Sydney, Australia, J-L. Berrod: Groupe Hospitalier Paris St Joseph, Paris, France, D. Binot: MCO Côte d’Opale, Boulogne sur Mer, France, M-J. Boudet: Clinique Alleray-Labrouste, Paris, France, J. Bousquet: Hôpital Privé de la Chataigneraie, Montpellier, France, D. Blazquez: Clinique Jeanne d’Arc, Paris, France, A. Bonan: Hôpital Privé d’Antony, Antony, France, O. Cas: Centre Médico Chirurgical Fondation WALLERSTEIN, Arès, France, A. Champault-Fezais: Groupe Hospitalier Paris St Joseph, Paris, France, P. Chastan: Bordeaux, France, J-L. Cardin: Polyclinique du Maine, Laval, France, J-M. Chollet: Hôpital Privé d’Antony, Antony, France, J-P. Cossa: CMC Bizet, Paris, France, A. Dabrowski: Clinique de Saint Omer, Saint Omer, France, S. Démaret: Clinique Saint Vincent, Besançon, France, F. Drissi: CHU Nantes, Nantes, France, J. Durou: Clinique de Villeneuve d’Ascq, Villeneuve d’Ascq, France, T. Dugue: Clinique de Saint Omer, Saint Omer, France, J-P. Faure: CHRU Poitiers, Poitiers, France, D. Framery: CMC de la Baie de Morlaix, Morlaix, France, G. Fromont: Clinique de Bois Bernard, Bois Bernard, France, A. Gainant: CHRU Limoges, Limoges, France, L. Gauduchon: CHRU Amiens, France, L. Genser: CHU Pitié-Sampétrière, Paris, France, J-F. Gillion: Hôpital Privé d’Antony, Antony, France, A. Guillaud: Clinique du Renaison, Roanne, France, C. Jacquin: CH du Prado, Marseille, France, F. Jurczak: Clinique Mutualiste, Saint Nazaire, France, H. Khalil: CHRU Rouen, Rouen, France, A. Lacroix: CH de Auch, Auch, France, P. Ledaguenel: Clinique Tivoli, Bordeaux, France, M. Lepère: Clinique Saint Charles, La Roche-sur-Yon, France, D. Lépront: Polyclinique de Navarre, Pau, France, N. Letoux: Clinique Jeanne d’Arc, Paris, France, J. Loriau: Groupe Hospitalier Paris St Joseph, Paris, E. Magne: Clinique Tivoli, Bordeaux, France, P. Ngo: Hôpital Américain, Neuilly, France, O. Oberlin: Croix St Simon Diaconesses, Paris, France, D. Paterne: Clinique Tivoli, Bordeaux, France, X. Pavis d’Escurac: Strasbourg, France, L. Potiron: Clinique Jules Verne, Nantes, France, Y. Renard: CHRU Reims, Reims, France, M. Soler: Polyclinique Saint Jean, Cagnes-sur-Mer, France.
Compliance with ethical standards
Conflict of interest
BR, JFG, POD and NM declare no conflict of interest.
The registry complies with the requirements of the French ‘Commission Nationale de l’Informatique et des Libertés’ (CNIL; registration number 1993959v0), and the different specific French ethics committees.
Human and animal rights
The study including human participants has been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments.
Informed consent was obtained from all patients prior to all surgical procedures.
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