PMID- 19106673
OWN - NLM
STAT- MEDLINE
DCOM- 20090122
LR  - 20220330
IS  - 1528-1140 (Electronic)
IS  - 0003-4932 (Linking)
VI  - 249
IP  - 1
DP  - 2009 Jan
TI  - Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) inguinal 
      hernia repair: a randomized, multicenter trial with 5-year follow-up.
PG  - 33-8
LID - 10.1097/SLA.0b013e31819255d0 [doi]
AB  - OBJECTIVES: To compare a laparoscopic (totally extraperitoneal patch (TEP)) and 
      an open technique (Lichtenstein) for inguinal hernia repair regarding recurrence 
      rate and possible risk factors for recurrence. SUMMARY BACKGROUND DATA: 
      Laparoscopic hernia repair has been introduced as an alternative to open repair. 
      Short-term follow-up suggests benefits for those patients operated with a 
      laparoscopic approach compared with open techniques; ie, less postoperative pain 
      and a shorter convalescence period. Long-term results, however, are less well 
      known. METHODS: The study was conducted as a multicenter randomized trial with a 
      5-year follow-up. A total of 1512 men aged 30 to 70 years, with a primary 
      unilateral inguinal hernia, were randomized to either TEP or Lichtenstein repair. 
      RESULTS: Overall, 665 patients in the TEP group and 705 patients in the 
      Lichtenstein group were evaluable. The cumulative recurrence rate was 3.5% in the 
      TEP group and 1.2% in the Lichtenstein group (P = 0.008). Test for heterogeneity 
      revealed significant differences between individual surgeons. The exclusion of 1 
      surgeon, who was responsible for 33% (7 of 21) of all recurrences in the TEP 
      group, lowered the cumulative recurrence rate to 2.4% in this group, which was 
      not statistically different from that of the Lichtenstein group. CONCLUSIONS: The 
      recurrence rate for both TEP and Lichtenstein repair was low. A higher cumulative 
      recurrence rate in the TEP group was seen at 5 years. Further analysis revealed 
      that this could be attributable to incorrect surgical technique.
FAU - Eklund, Arne S
AU  - Eklund AS
AD  - Department of Surgery and Centre of Clinical Research Uppsala Universitet, 
      Central Hospital Vasteras, Vasteras, Sweden. arne.eklund@ltv.se
FAU - Montgomery, Agneta K
AU  - Montgomery AK
FAU - Rasmussen, Ib C
AU  - Rasmussen IC
FAU - Sandbue, Rune P
AU  - Sandbue RP
FAU - Bergkvist, Leif A
AU  - Bergkvist LA
FAU - Rudberg, Claes R
AU  - Rudberg CR
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Ann Surg
JT  - Annals of surgery
JID - 0372354
SB  - IM
CIN - Ann Surg. 2009 Aug;250(2):353-4; author reply 354. PMID: 19648813
CIN - Ann Surg. 2009 Aug;250(2):354-5; author reply 355. PMID: 19648815
MH  - Adult
MH  - Aged
MH  - Follow-Up Studies
MH  - Hernia, Inguinal/*surgery
MH  - Humans
MH  - *Laparoscopy
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Surgical Procedures, Operative/methods
MH  - Time Factors
EDAT- 2008/12/25 09:00
MHDA- 2009/01/23 09:00
CRDT- 2008/12/25 09:00
PHST- 2008/12/25 09:00 [entrez]
PHST- 2008/12/25 09:00 [pubmed]
PHST- 2009/01/23 09:00 [medline]
AID - 00000658-200901000-00007 [pii]
AID - 10.1097/SLA.0b013e31819255d0 [doi]
PST - ppublish
SO  - Ann Surg. 2009 Jan;249(1):33-8. doi: 10.1097/SLA.0b013e31819255d0.