Patient-reported outcome measures after laparoscopic totally extra-peritoneal versus open anterior repair of inguinal hernia

Abstract

Background: This prospective single-center case-control study evaluates the differences in patient-reported outcomes between endoscopic totally extraperitoneal (TEP) and open anterior repair (OR) of inguinal hernia. Methods: Seventy-two patients scheduled for elective inguinal hernia repair were divided into 2 groups: the OR group (35 patients) and the TEP group (37 patients). All but 1 patient filled out the questionnaire during their preoperative consultation and at 1–3–6–12 months postoperative follow-up. Results: A unilateral hernia was present in all the patients of the open group and in 10 patients (27%) of the TEP group (P < 0.001). At 1 and at 3 months, significantly more patients in the TEP group reported no pain (59.5% vs 29.5%, P = 0.03; 75.7% vs 47.1%, P = 0.02), did not have any groin problems interfering with work activity (67.6% vs 32.3%, P = 0.04; 78.4% vs 50.0%, P = 0.02), and felt very satisfied about surgery (78.4% vs 41.2%, P = 0.01; 83.8% vs 64.7%, P = 0.04). At 1 month, significantly more patients in the OR group cut down on the usual things (55.9% vs 5.4%, P < 0.001) and did not work (53% vs 8.1%, P < 0.001) for more than 21 days for their groin problems. At 1,3, 6 and 12 months follow-up, significantly more patients in the TEP group perceived that the operation helped them (86.5% vs 50%, P = 0.003; 94.6% vs 61.8%, P = 0.001; 91.9% vs 70.5%, P = 0.02; 91.9% vs 73.6%, P = 0.035). Conclusions: TEP is characterized by a significant improvement in patient-reported outcomes measures, with clear advantages regarding quality of life and recovery rate, in comparison with traditional OR.