Comparison of early and long term outcomes of open Lichtenstein repair and totally extraperitoneal herniorrhaphy for primary inguinal hernias

Abstract

Background/aim: Inguinal hernia repair is one of the most common surgical procedures worldwide. There is still controversy overwhich method has the best postoperative results. The aim of this study was to compare early and late postoperative results of laparoscopictotally extraperitoneal herniorrhaphy (TEP) and open Lichtenstein herniorrhaphy (OLR).Materials and methods: The study was conducted in a randomized prospective manner and it was concluded with 302 patients (147cases in TEP group and 155 cases in OLR group). All procedures were performed by two experienced surgeons in both open andlaparoscopic inguinal hernia repair.Results: The groups were similar in terms of age, sex, and types of inguinal hernia according to Nyhuss classification. The mean operationtime was shorter in TEP group with 49.2 ± 15.5 min vs 54.3 ± 14.6 min in OLR group (P = 0.004). The mean length of hospital stay wassignificantly shorter in TEP group (P = 0.001). The mean postoperative visual analogue scale score was significantly lower in TEP group.With a mean follow-up of 40.95 months, the recurrence rates were similar in both groups with a rate of 4.3%. In terms of chronic pain,TEP group has better results than OLR with 3.4% vs 25.2%, respectively (P = 0.001).Conclusion: In experienced hands, TEP procedure has better early and late postoperative results than OLR, whereas recurrence ratesare similar.