Clin Ter. 2025 Nov-Dec;176(6):708-716. doi: 10.7417/CT.2025.5287.
ABSTRACT
To assess and compare the long-term postoperative complications, postoperative pain incidences, and hernia recurrence rates following surgery for inguinal hernias using different surgical approaches, namely transabdominal preperitoneal (TAPP), TAPP with the internal ring suturing (TAPP-IRS), Liechtenstein technique, and Shouldice technique. This study is a multicentre clinical trial that involves 302 patients ranging from 18 to 74 years old (with an average age of 55.4±10.6 years). Among the participants, there were 49 women (16.2%) and 253 men (83.8%), all diagnosed with primary inguinal hernias. Out of the total, 216 patients (71.5%) had a normal body mass index, 77 patients (25.5%) were overweight, and 9 patients (7%) were obese. The interventions utilized in the study included open techniques such as the Liechtenstein technique (121 patients) and the Shouldice technique (27 patients), as well as the laparoscopic technique using the TAPP approach (98 patients), with 56 of them undergoing the modified procedure involving internal ring suturing. The study aimed to assess the frequency and severity of chronic postoperative pain and postoperative complications such as testicular edema, infiltration, suppuration, and urinary retention within a year and the recurrence rate of an inguinal hernia within two years. The occurrence and intensity of chronic pain syndrome were moderate, with no significant differences observed between the different surgical approaches. The overall hernia recurrence rate during the two-year follow-up period was 2.8%, and no significant differences were observed among the surgical methods used except the TAPP-IRS method. Notably, the TAPP-IRS subgroup had no reported cases of recurrence. The patients’ weight was identified as the most significant risk factor, followed by the choice of intervention technique. It is important to consider the TAPP-IRS subgroup, which exhibited no instances of recurrence. The type of intervention had a minimal impact on the risk of recurrence and other post-operational complications, primarily due to limitations in open surgical procedures and the technique of the TAPP-IRS. During the postoperative period for indirect inguinal hernia repair, the laparoscopic method results in a lower incidence and less severe postoperative pain at one month compared to open hernioplasty. However, by the 12-month mark, the pain subsides, and both methods exhibit comparable characteristics.
PMID:41267586 | DOI:10.7417/CT.2025.5287
