Bilateral and Unilateral Total Extraperitoneal Inguinal Hernia Repair TEP have Equivalent Early Outcomes: Analysis of 9395 CasesReport as inadecuate

Bilateral and Unilateral Total Extraperitoneal Inguinal Hernia Repair TEP have Equivalent Early Outcomes: Analysis of 9395 Cases - Download this document for free, or read online. Document in PDF available to download.

World Journal of Surgery

, Volume 39, Issue 8, pp 1887–1894

First Online: 02 April 2015


IntroductionTo date, no randomized controlled trials have been carried out to compare the perioperative outcome of unilateral and bilateral inguinal hernia repair using an endoscopic technique. In a Swiss registry study comparing unilateral with bilateral inguinal hernias, no further details were given regarding the nature of the intra- and postoperative complications. In addition, some authors have raised the issue of prophylactic repair of a clinically healthy other groin side.

Patients and methodsIn the Herniamed Registry, in total 9395 patients with a TEP were enrolled. These comprised 6700 patients with unilateral 71.31 % and 2695 patients 28.69 % with bilateral inguinal hernia repair. The outcome variables, analyzed in a multivariable model, were the intra- and postoperative as well as general complication rates, reoperation rate, duration of operation, and length of hospital stay.

ResultsWhile no significant difference was found in the overall number of intraoperative complications between the unilateral and bilateral group p = 0.310, a significantly higher number of urinary bladder injuries in the bilateral TEP operation of 0.28 % compared with 0.04 % for unilateral TEP p = 0,008 were noted. The greater probability of reoperation 0.82 % for unilateral vs. 1.78 % for bilateral TEP; p < 0,001 in the unadjusted analysis was confirmed in the multivariable model OR 2.35 1.504; 3.322; p = 0.001.

SummaryA significantly higher intraoperative urinary bladder injury rate and reoperation rate because of postoperative surgical complications constitute a difference in the perioperative outcome between unilateral and bilateral TEP which that warrants attention. Based on these results, prophylactic operation of the healthy other groin should not be recommended.

Electronic supplementary materialThe online version of this article doi:10.1007-s00268-015-3055-z contains supplementary material, which is available to authorized users.

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Author: F. Köckerling - C. Schug-Pass - D. Adolf - T. Keller - A. Kuthe


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