Abstract
To investigate long-term chronic postoperative inguinal pain (CPIP), QoL and recurrence in patients with a primary inguinal hernia comparing TEP to Lichtenstein. A questionnaire-based follow-up containing the Inguinal Pain Questionnaire (IPQ), the Cunningham Pain Scale and SF-36 was done 8years after the TEPLICH RCT. The main objective was non-ignorable pain last week according to IPQ. A phone interview was performed with patients reporting new non-ignorable pain and those having a suspected recurrence. Records were scanned for long-term CPIP and recurrences. A lost to follow-up analysis was performed. A total of 322 of 366 patients (88%) completed the follow-up of mean 7.94years (5-10.75years). Non-ignorable pain last week was reported by 7.6% in TEP and 6.7% in Lichtenstein (p < 0.73). New non-ignorable pain was reported by 5 patients. No difference in non-ignorable pain over time (1-8years) was observed within groups. Moderate to severe pain, according to Cunningham, was reported by 3.8% in TEP and 5.5% in Lichtenstein (p < 0.48). QoL remained above the Swedish norm. No recurrences occurred after 3years follow-up. The lost to follow-up analysis showed no difference in non-ignorable pain. RCTs, comparing TEP to Lichtenstein repair with follow-up ≥ 5years regarding CPIP are sparse with conflicting data. In this study, low frequencies of CPIP present at 3years seem to persist at 8years. Recurrences occured within the first 3years. Patients need to be informed of the risk of long-term CPIP.
Published Version
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