Transabdominal preperitoneal versus totally extraperitoneal repair of inguinal hernia: a meta-analysis of randomized studies |
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Authors: | Stavros A. Antoniou George A. Antoniou Detlef K. Bartsch Volker Fendrich Oliver O. Koch Rudolph Pointner Frank A. Granderath |
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Affiliation: | 1. Department of General and Visceral Surgery, Center for Minimally Invasive Surgery, Hospital Neuwerk, Mönchengladbach, Germany;2. Department of Visceral, Thoracic and Vascular Surgery, Philipps University Marburg, Marburg, Germany;3. Department of Vascular and Endovascular Surgery, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK;4. Department of General Surgery, Hospital Zell am See, Zell am See, Austria |
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Abstract: | BackgroundThe aim of the present study was to comparatively evaluate the outcomes of laparoscopic transabdominal preperitoneal inguinal hernia repair and totally extraperitoneal repair.MethodsThe electronic databases of Medline, EMBASE, and the Cochrane Central Register of Controlled Trials were searched, and a meta-analysis of randomized clinical trials was undertaken.ResultsSeven studies comprising 516 patients with 538 inguinal hernia defects were identified. A shorter recovery time (P = .02) was found for totally extraperitoneal repair in comparison with transabdominal preperitoneal inguinal hernia repair (weighted mean difference = −.29; 95% confidence interval [CI], −.71 to .07) although the length of hospitalization (P = .89) was similar in the 2 treatment arms (weighted mean difference = .01; 95% CI, −.13 to .15). Operative morbidity (P = .004) was higher for the preperitoneal approach (odds ratio = 2.15; 95% CI, 1.29 to 3.61). No differences were found with regard to the incidence of recurrence, long-term neuralgia, and operative time.ConclusionsCurrent evidence suggests similar operative results for endoscopic and laparoscopic inguinal hernia repair, with a trend toward higher morbidity for the preperitoneal approach. Randomized trials with a longer-term follow-up are needed in order to assess the effect of each approach on the prevention of recurrence. |
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Keywords: | Endoscopy Laparoscopy Transabdominal preperitoneal Totally extraperitoneal Transabdominal preperitoneal inguinal hernia repair Totally extraperitoneal repair |
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