Abstract
Objectives
The aim of this study was to compare the effect of transabdominal preperitoneal (TAPP) inguinal hernioplasty with or without mesh fixation on chronic pain and quality of life of patients.
Methods
One hundred patients with a simple oblique inguinal hernia were included and treated at the Second Affiliated Hospital of Kunming Medical University from July of 2015 to July of 2016. Patients were randomly assigned to TAPP inguinal hernioplasty with mesh fixation (fixation group, n = 50) or without mesh fixation (non-fixation group, n = 50). Observation indices such as mean operative time, time to ambulation, hospitalization expense, and complications were recorded. The visual analog scale (VAS) was adopted for pain evaluation 2 days, 3 months, and 6 months postoperatively. The 36-item short-form health survey (SF-36) was adopted for life quality scoring 3 months postoperatively.
Results
No recurrence or incisional infections were observed during follow-up in either group. The mean operative time, time to ambulation, and hospitalization expense of the non-fixation group were all significantly reduced compared to those of the fixation group. The VAS score 2 days, 3 months, and 6 months postoperatively of the non-fixation group were significantly lower than in the fixation group. The physical function, role physical, bodily pain, and general health in the non-fixation group were each significantly higher than in the fixation group. In contrast, vitality, social function, role emotional, and mental health showed no significant differences across groups.
Conclusions
For patients with primary unilateral oblique inguinal hernia with a defect size less than 4.0 cm in diameter, TAPP inguinal hernioplasty without mesh fixation was safe and effective. Furthermore, this shortened the operative time, promoted early ambulation, decreased hospitalization expenses, alleviated postoperative pain, and improved quality of life.
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Acknowledgements
The authors are thankful to the Second Affiliated Hospital of Kunming Medical University for the management of our inguinal hernia patient database. This work was supported by the Wu Jieping Medical Foundation of China (No. 320.6750.16211).
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Drs. Weiming Li, Dali Sun, Yanbo Sun, Yunyun Cen, Shumin Li, Qingwen Xu, Yijun Li, Yuxing Qi, Yueying Lin, Ting Yang, and Pengyuan Xu have no conflicts of interest or financial ties to disclose.
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Weiming Li and Dali Sun have contributed equally to this work.
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Li, W., Sun, D., Sun, Y. et al. The effect of transabdominal preperitoneal (TAPP) inguinal hernioplasty on chronic pain and quality of life of patients: mesh fixation versus non-fixation. Surg Endosc 31, 4238–4243 (2017). https://doi.org/10.1007/s00464-017-5485-1
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DOI: https://doi.org/10.1007/s00464-017-5485-1