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Sixty-month follow-up after endoscopic inguinal hernia repair with three types of mesh: a prospective randomized trial

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Abstract

Background

This prospective, clinical, randomized, double-blind study was intended to investigate the impact of the structure and the amount of polypropylene (PP) mesh used in laparoscopic transabdominal preperitoneal hernioplastic (TAPP) on physical function and life quality.

Methods

180 male patients with primary inguinal hernia undergoing TAPP were randomized for using a heavyweight (108 g/m2), double-filament PP mesh (Prolene, 10 × 15 cm, group A, n = 60), a multifilament, heavyweight variant (116 g/m2) of PP mesh (Serapren, 10 × 15 cm, group B, n = 60), or a composite mesh (polyglactin and PP) (Vypro II, 10 × 15 cm, group C, n = 60). We compared in terms of complications (seromas, recurrence rate) and life quality (pain development, physical function). The development of life quality was documented according to the SF-36 Health Survey. The follow-up period was 60 months.

Results

The recurrence rate (2.2% overall) during 60-month follow-up was not significantly different between the groups. Convalescence in group A was slower than in groups B and C: mean-term values of the visual scales for pain development were significantly (p < 0.05) higher, incapacity for work was 8.2 days longer, and urological adverse effects were stronger. The mean-term development of life quality was significantly lower in group A up to 12th week postoperatively. There were no significant differences between groups B and C. Beyond the 12th postinterventional week the differences diminished.

Conclusions

The composite mesh does not provide an advantage concerning physical function or pain development in comparison to the multifilament, heavyweight, pure polypropylene mesh. Independently of which mesh was implanted 5% of patients are still suffering from discomfort after 5 years.

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Authors and Affiliations

  1. Department of Surgery, Helios Klinikum Wuppertal, University of Witten-Herdecke, Heusner-Strasse 40, 42283, Wuppertal, Germany

    Mike Ralf Langenbach & Hubert Zirngibl

  2. Department of Surgery, Evangelisches Krankenhaus Lutherhaus, Hellweg 100, 45276, Essen, Germany

    Johannes Schmidt

  3. Department of Urology, Helios Klinikum Wuppertal, University of Witten/Herdecke, Heusnerstr. 40, 42283, Wuppertal, Germany

    Burkhard Ubrig

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  1. Mike Ralf Langenbach
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  2. Johannes Schmidt
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  4. Hubert Zirngibl
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Correspondence to Mike Ralf Langenbach.

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Langenbach, M.R., Schmidt, J., Ubrig, B. et al. Sixty-month follow-up after endoscopic inguinal hernia repair with three types of mesh: a prospective randomized trial. Surg Endosc 22, 1790–1797 (2008). https://doi.org/10.1007/s00464-008-9863-6

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  • DOI: https://doi.org/10.1007/s00464-008-9863-6

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