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Currently, there is a controversy regarding the best approach for simultaneous repair of bilateral inguinal hernia. The aim of this study was to compare the outcome of laparoscopic versus open repair of bilateral inguinal hernia
This prospective randomized study included 120 consecutive patients with bilateral primary inguinal hernia treated at Alexandria university hospital in the period between June 2014 and February 2017. Patients were randomized by sealed envelopes into 3 groups, each includes 40 patients. Group I treated by laparoscopic transabdominal preperitoneal repair using 2 separate meshes, Group II treated by open preperitoneal mesh repair, while Group III treated by bilateral Lichtenstein repair. The 3 groups were compared regarding: operative time, postoperative complications, pain, hospital stay, return to normal activity and work, chronic groin pain, patient's satisfaction and 3 years recurrence rate.
Statistical Analysis: Numerical data in both groups was expressed as mean
± standard deviation (SD) and compared using One-way analysis of variance while categorical data was expressed as percentages and compared using Chi-squared test. Logistic regression test was used to determine predictors of postoperative complications. Differences were considered significant at p <0.05.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lap TAPP Group | Active Comparator | Patients treated by laparoscopic transabdominal preperitoneal repair using 2 separate meshes fixed by laparoscopic tackers |
|
| Open PP Group | Active Comparator | Patients treated by open preperitoneal single mesh repair fixated using sutures |
|
| Bilateral LICHT Group | Active Comparator | Patients treated by standard bilateral Lichtenstein repair using 2 separate meshes fixed by sutures |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bilateral TAPP Repair | Procedure | laparoscopic transabdominal preperitoneal repair using 2 separate meshes fixed by laparoscopic tackers |
|
| Measure | Description | Time Frame |
|---|---|---|
| Operative time | Operative time (in minutes) | Same day of surgery |
| Postoperative pain 7 days after surgery | Pain intensity was assessed using the pain visual analogue scale (VAS) with values ranging from 1 (no pain) to 10 (worst possible pain) | 7 days after surgery |
| Early postoperative complications | Any complications related to surgery developed within 30 days after the surgery | 30 days after the surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Chronic postoperative pain | Groin pain related to surgery lasting for more than 3 months after surgery | 3 months after surgery |
| Hernia recurrence | Unilateral or bilateral - residual or recurrent hernia within 3 years after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mohamed Elmessiry | Ass. Professor of Surgery | Principal Investigator |
| Ahmed Gebaly | Ass. Professor of Surgery | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20960019 | Background | Feliu X, Claveria R, Besora P, Camps J, Fernandez-Sallent E, Vinas X, Abad JM. Bilateral inguinal hernia repair: laparoscopic or open approach? Hernia. 2011 Feb;15(1):15-8. doi: 10.1007/s10029-010-0736-2. Epub 2010 Oct 21. | |
| 11525372 | Background | Sarli L, Iusco DR, Sansebastiano G, Costi R. Simultaneous repair of bilateral inguinal hernias: a prospective, randomized study of open, tension-free versus laparoscopic approach. Surg Laparosc Endosc Percutan Tech. 2001 Aug;11(4):262-7. doi: 10.1097/00129689-200108000-00007. |
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No consent to share IPD
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| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D012008 | Recurrence |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D020969 | Disease Attributes |
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This prospective study included 120 consecutive patients with bilateral primary inguinal hernia managed by simultaneous bilateral repair. Patients were randomized by sealed opaque envelopes containing computer generated random numbers into 3 groups, each includes 40 patients. Group I treated by laparoscopic transabdominal preperitoneal repair using 2 separate meshes (Lap TAPP), Group II treated by open preperitoneal mesh repair with mesh fixation (Open PP), while Group III treated by standard bilateral Lichtenstein repair (LICHT group).
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| Open PP Repair | Procedure | Open pre-peritoneal repair using single mesh fixed by sutures |
|
| Bilateral Lichtenstein Repair | Procedure | Bilateral Lichtenstein Repair using 2 separate meshes fixed by sutures |
|
| 3 years after surgery |
| 12802653 | Background | Mahon D, Decadt B, Rhodes M. Prospective randomized trial of laparoscopic (transabdominal preperitoneal) vs open (mesh) repair for bilateral and recurrent inguinal hernia. Surg Endosc. 2003 Sep;17(9):1386-90. doi: 10.1007/s00464-002-9223-x. Epub 2003 Jun 17. |