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Bilateral and Unilateral Total Extraperitoneal Inguinal Hernia Repair (TEP) have Equivalent Early Outcomes: Analysis of 9395 Cases
INTRODUCTION: To 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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496500/ https://www.ncbi.nlm.nih.gov/pubmed/25832474 http://dx.doi.org/10.1007/s00268-015-3055-z |
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author | Köckerling, F. Schug-Pass, C. Adolf, D. Keller, T. Kuthe, A. |
author_facet | Köckerling, F. Schug-Pass, C. Adolf, D. Keller, T. Kuthe, A. |
author_sort | Köckerling, F. |
collection | PubMed |
description | INTRODUCTION: To 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 METHODS: In 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. RESULTS: While 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]. SUMMARY: A 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 MATERIAL: The online version of this article (doi:10.1007/s00268-015-3055-z) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4496500 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-44965002015-07-15 Bilateral and Unilateral Total Extraperitoneal Inguinal Hernia Repair (TEP) have Equivalent Early Outcomes: Analysis of 9395 Cases Köckerling, F. Schug-Pass, C. Adolf, D. Keller, T. Kuthe, A. World J Surg Original Scientific Report INTRODUCTION: To 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 METHODS: In 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. RESULTS: While 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]. SUMMARY: A 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 MATERIAL: The online version of this article (doi:10.1007/s00268-015-3055-z) contains supplementary material, which is available to authorized users. Springer International Publishing 2015-04-02 2015 /pmc/articles/PMC4496500/ /pubmed/25832474 http://dx.doi.org/10.1007/s00268-015-3055-z Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Scientific Report Köckerling, F. Schug-Pass, C. Adolf, D. Keller, T. Kuthe, A. Bilateral and Unilateral Total Extraperitoneal Inguinal Hernia Repair (TEP) have Equivalent Early Outcomes: Analysis of 9395 Cases |
title | Bilateral and Unilateral Total Extraperitoneal Inguinal Hernia Repair (TEP) have Equivalent Early Outcomes: Analysis of 9395 Cases |
title_full | Bilateral and Unilateral Total Extraperitoneal Inguinal Hernia Repair (TEP) have Equivalent Early Outcomes: Analysis of 9395 Cases |
title_fullStr | Bilateral and Unilateral Total Extraperitoneal Inguinal Hernia Repair (TEP) have Equivalent Early Outcomes: Analysis of 9395 Cases |
title_full_unstemmed | Bilateral and Unilateral Total Extraperitoneal Inguinal Hernia Repair (TEP) have Equivalent Early Outcomes: Analysis of 9395 Cases |
title_short | Bilateral and Unilateral Total Extraperitoneal Inguinal Hernia Repair (TEP) have Equivalent Early Outcomes: Analysis of 9395 Cases |
title_sort | bilateral and unilateral total extraperitoneal inguinal hernia repair (tep) have equivalent early outcomes: analysis of 9395 cases |
topic | Original Scientific Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4496500/ https://www.ncbi.nlm.nih.gov/pubmed/25832474 http://dx.doi.org/10.1007/s00268-015-3055-z |
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