Could long-term follow-up modify the outcomes after laparoscopic TAPP? A 5-year retrospective cohort study
Laparoscopic inguinal hernia repair (LIHR) has demonstrated multiple benefits. However, long-term results regarding recurrence and quality of life (QoL) are still on debate. We aimed to analyze postoperative outcomes with long-term follow-up after LIHR.
A consecutive series from December 2012 to May 2017 of laparoscopic TAPP was included. A minimum of 6 months of follow-up was required for inclusion. The sample was divided into two groups, G1: patients with recurrence and G2: patients without recurrence. Patient’s characteristics, operative variables and postoperative outcomes were analyzed. A QoL survey (Eura-HS QoL) was performed in the pre- and postoperative period.
A total of 717 laparoscopic TAPP were performed in 443 patients. On univariate analysis, smoking, previous recurrence, mesh size smaller than 12 × 15 cm and surgical teams with less than 30 cases/year showed an increased recurrence rate (p < 0.05). But only smoking and less experienced teams were statistically significant on multivariate analysis (p < 0.01). After a 2-year follow-up, recurrence rate was 1.5%, while it increased to 2.6% (n = 19) at 5-year follow-up. Sixty percent of patients answered QoL survey. Average preoperative scores of pain, activities restriction and aesthetic dissatisfaction improved significantly after 6 months of follow-up in patients without recurrence.
After LIHR, quality of life shows a significant improvement in all parameters. Extending follow-up beyond 2 years after laparoscopic TAPP allows a more accurate assessment of recurrence rate. Smoking and inexperienced teams were significant risk factors for its development.
KeywordsLaparoscopic inguinal hernia Recurrence Risk factors Quality of life
Compliance with ethical standards
Conflict of interest
Drs. Peña, Dreifuss, Schlottmann and Sadava have no conflicts of interest or financial ties to disclosure.
The Hospital Alemán of Buenos Aires Institutional Review Board reviewed and approved this study.
Human and animal rights
The study including human participants has been performed in concordance with ethical standards of the Declaration of Helsinki and its later amendments.
For this study, formal consent was not required.
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