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Open Mesh Repair for Inguinal Hernia is Safer than Laparoscopic Repair or Open Non-mesh Repair: A Nationwide Registry Study of Complications

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Abstract

Background

Inguinal hernia repair is the most common elective procedure in general surgery. Therefore, the number of patients having complications related to inguinal hernia surgery is relatively large. The aim of this study was to compare complication profiles of inguinal open mesh (OM) hernioplasties with open non-mesh (OS) repairs and laparoscopic (LAP) repairs using retrospective nationwide registry data.

Methods

The database of the Finnish Patient Insurance Centre (FPIC) was searched for complications of inguinal and femoral hernia repairs during 2002–2010. Complications of OM repairs were compared to complications of OS repairs and LAP repairs.

Results

Over 75 % of all inguinal hernia procedures during the study period in Finland were OM hernioplasties. FPIC received 245 complication reports after OM repairs, 40 after OS repairs, and 50 after LAP repairs. Reported complications were significantly more severe after LAP and OS repairs than OM surgery (p < 0.001). Visceral complications (p < 0.001), deep infections (p < 0.001), and deep hemorrhagic complications (p < 0.001) were overrepresented in the LAP group. In the OS group, visceral complications (p < 0.001), recurrences (p < 0.001), and severe neuropathic pain (p < 0.001) predominated.

Conclusion

LAP and OS repairs of inguinal hernia were associated with more severe complications than open surgery with mesh in this study.

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References

  1. Bittner R, Schwarz J (2012) Inguinal hernia repair: current surgical techniques. Langenbecks Arch Surg 397(2):271–282

    Article  CAS  PubMed  Google Scholar 

  2. Paajanen H, Scheinin T, Vironen J (2010) Commentary: nationwide analysis of complications related to inguinal hernia surgery in Finland: a 5 year register study of 55,000 operations. Am J Surg 199(6):746–751

    Article  PubMed  Google Scholar 

  3. Aasvang EK, Bay-Nielsen M, Kehlet H (2006) Pain and function impairment 6 years after inguinal herniorrhaphy. Hernia 10(4):316–321

    Article  CAS  PubMed  Google Scholar 

  4. Lundström KJ, Sandblom G, Smedberg S et al (2012) Risk factors for complications in groin hernia surgery: a national register study. Ann Surg 255(4):784–788

    Article  PubMed  Google Scholar 

  5. Burcharth J, Andresen K, Pommergaard HC et al (2014) Recurrence patterns of direct and indirect inguinal hernias in a nationwide population in Denmark. Surgery 155(1):173–177

    Article  PubMed  Google Scholar 

  6. Rantanen TK, Oksala NK, Oksala AK et al (2008) Complications in antireflux surgery: national-based analysis of laparoscopic and open fundoplications. Arch Surg 143(4):359–365

    Article  PubMed  Google Scholar 

  7. Keskimäki I, Aro S (1991) Accuracy of data on diagnoses, procedures and accidents in the Finnish hospital discharge register. Int J Health Sci 2(1):15–21

    Google Scholar 

  8. Bittner R, Arregui ME, Bisgaard T et al (2011) Guidelines for laparoscopic (TAPP) and endoscopic (TEP) treatment of inguinal hernia [International Endohernia Society (IEHS)]. Surg Endosc 25(9):2773–2843

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Felix EL, Michas CA, Gonzalez MH Jr (1995) Laparoscopic hernioplasty TAPP vs. TEP. Surg Endosc 9(9):984–989

    Article  CAS  PubMed  Google Scholar 

  10. Lepere M, Benchetrit S, Debaert M et al (2000) A multicentric comparison of transabdominal versus totally extraperitoneal laparoscopic hernia repair using PARIETEX meshes. JSLS 4(2):147–153

    CAS  PubMed Central  PubMed  Google Scholar 

  11. Bobrzynski A, Budzynski A, Biesiada Z et al (2001) Experience—the key factor in successful laparoscopic total extraperitoneal and transabdominal preperitoneal hernia repair. Hernia 5(2):80–83

    Article  CAS  PubMed  Google Scholar 

  12. Schultz C, Baca I, Götzen V (2001) Laparoscopic inguinal hernia repair. Surg Endosc 15(6):582–584

    Article  CAS  PubMed  Google Scholar 

  13. Vanclooster P, Smet B, de Gheldere C et al (2001) Laparoscopic inguinal hernia repair: review of 6 years experience. Acta Chir Belg 101(3):135–138

    CAS  PubMed  Google Scholar 

  14. Bittner R, Schmedt CG, Schwarz J et al (2002) Laparoscopic transperitoneal procedure for routine repair of groin hernia. Br J Surg 89(8):1062–1066

    Article  CAS  PubMed  Google Scholar 

  15. Tamme C, Scheidbach H, Hampe C et al (2003) Totally extraperitoneal endoscopic inguinal hernia repair (TEP). Surg Endosc 17(2):190–195

    Article  CAS  PubMed  Google Scholar 

  16. Dulucq JL, Wintringer P, Mahajna A (2009) Laparoscopic totally extraperitoneal inguinal hernia repair: lessons learned from 3100 hernia repairs over 15 years. Surg Endosc 23(3):482–486

    Article  PubMed  Google Scholar 

  17. McCormack K, Scott NW, Go PM, EU Hernia Trialists Collaboration et al (2003) Laparoscopic techniques versus open techniques for inguinal hernia repair. Cochrane Database Syst Rev 1:CD001785

    PubMed  Google Scholar 

  18. Schmedt CG, Sauerland S, Bittner R (2005) Comparison of endoscopic procedures vs Lichtenstein and other open mesh techniques for inguinal hernia repair: a meta-analysis of randomized controlled trials. Surg Endosc 19(2):188–199

    Article  CAS  PubMed  Google Scholar 

  19. Scott N, Go PM, Graham P et al (2001) Open mesh versus non-mesh for groin hernia repair. Cochrane Database Syst Rev 3:CD002197

    Google Scholar 

  20. Cohen RV, Alvarez G, Roll S et al (1998) Transabdominal or totally extraperitoneal laparoscopic hernia repair? Surg Laparosc Endosc 8(4):264–268

    Article  CAS  PubMed  Google Scholar 

  21. Van Hee R, Goverde P, Hendrickx L et al (1998) Laparoscopic transperitoneal versus extraperitoneal inguinal hernia repair: a prospective clinical trial. Acta Chir Belg 98(3):132–135

    PubMed  Google Scholar 

  22. Kapiris SA, Brough WA, Royston CM et al (2001) Laparoscopic transabdominal preperitoneal (TAPP) hernia repair. A 7-year two-center experience in 3017 patients. Surg Endosc 15(9):972–975

    Article  CAS  PubMed  Google Scholar 

  23. Ramshaw B, Shuler FW, Jones HB et al (2001) Laparoscopic inguinal hernia repair: lessons learned after 1224 consecutive cases. Surg Endosc 15(1):50–54

    Article  CAS  PubMed  Google Scholar 

  24. Wright DM, Kennedy A, Baxter J et al (1996) Early outcome after open versus extraperitoneal endoscopic tension-free hernioplasty: a randomized clinical trial. Surgery 119(5):552–557

    Article  CAS  PubMed  Google Scholar 

  25. Wellwood J, Sculpher MJ, Stoker D et al (1998) Randomised trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost. BMJ 317(7151):103–110

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Johansson B, Hallerback B, Gilse H et al (1999) Laparoscopic mesh versus open preperitoneal mesh versus conventional technique for inguinal hernia repair: a randomized multicenter trial (SCUR Hernia Repair Study). Ann Surg 230(2):225–231

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  27. Andersson B, Hallen M, Leveau P et al (2003) Laparoscopic extraperitoneal inguinal hernia repair versus open mesh repair: a prospective randomized controlled trial. Surgery 133(5):464–472

    Article  PubMed  Google Scholar 

  28. Mahon D, Decadt B, Rhodes M (2003) Prospective randomized trial of laparoscopic (transabdominal preperitoneal) vs open (mesh) repair for bilateral and recurrent inguinal hernia. Surg Endosc 17(9):1386–1390

    Article  CAS  PubMed  Google Scholar 

  29. Heikkinen T, Bringman S, Ohtonen P et al (2004) Five-year outcome of laparoscopic and Lichtenstein hernioplasties. Surg Endosc 18(3):518–522

    Article  CAS  PubMed  Google Scholar 

  30. Eklund A, Rudberg C, Smedberg S et al (2006) Short-term results of a randomized clinical trial comparing Lichtenstein open repair with totally extraperitoneal laparoscopic inguinal hernia repair. Br J Surg 93(9):1060–1068

    Article  CAS  PubMed  Google Scholar 

  31. Khoury N (1995) A comparative study of laparoscopic extraperitoneal and transabdominal preperitoneal herniorrhaphy. J Laparoendosc Surg 5(6):349–355

    Article  CAS  PubMed  Google Scholar 

  32. Kozol R, Lange PM, Kosir M et al (1997) A prospective, randomised study of open vs laparoscopic inguinal hernia repair. An assessment of postoperative pain. Arch Surg 132(3):292–295

    Article  CAS  PubMed  Google Scholar 

  33. Zieren J, Zieren HU, Jacobi CA et al (1998) Prospective randomized study comparing laparoscopic and open tension-free inguinal hernia repair with Shouldice’s operation. Am J Surg 175(4):330–333

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

Drs. Sanna Kouhia, Jaana Vironen, Tapio Hakala and Hannu Paajanen have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Surgery, North Karelia Central Hospital, Joensuu, Finland

    Sanna Kouhia & Tapio Hakala

  2. Department of Gastrointestinal Surgery, Helsinki University Hospital, Helsinki, Finland

    Jaana Vironen

  3. Department of Surgery, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland

    Sanna Kouhia & Hannu Paajanen

Authors
  1. Sanna Kouhia
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  2. Jaana Vironen
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  3. Tapio Hakala
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  4. Hannu Paajanen
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Corresponding author

Correspondence to Sanna Kouhia.

Additional information

The study protocol was approved by the FPIC and the local ethics committee. This study is registered as “Complications in Inguinal Hernia Surgery” in https://clinicaltrials.gov–databasewith the identifier NCT01760395.

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Kouhia, S., Vironen, J., Hakala, T. et al. Open Mesh Repair for Inguinal Hernia is Safer than Laparoscopic Repair or Open Non-mesh Repair: A Nationwide Registry Study of Complications. World J Surg 39, 1878–1884 (2015). https://doi.org/10.1007/s00268-015-3028-2

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  • DOI: https://doi.org/10.1007/s00268-015-3028-2

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