Abstract | OBJECTIVE: The aim of this study was to compare chronic postoperative inguinal pain ( CPIP) in patients with an inguinal hernia after the TransREctus Sheath PrePeritoneal (TREPP) and the TransInguinal PrePeritoneal Technique ( TIPP). BACKGROUND: The preperitoneal mesh position for inguinal hernia repair showed beneficial results regarding CPIP with low recurrence rates. Two open preperitoneal techniques, TREPP and TIPP, were compared in a randomized clinical trial with the hypothesis of fewer patients with CPIP after TREPP due to complete avoidance of nerve contact. METHODS: Adult patients with a primary unilateral inguinal hernia were randomized to either TREPP or TIPP in four hospitals. Before the trial's start the study protocol was ethically approved and published. Outcomes included CPIP after 1 year (primary outcome) and recurrence rates, adverse events, and health-related quality of life (secondary outcomes). Follow-up was performed at 2 weeks, 6 months, and 1 year. RESULTS: Baseline characteristics were comparable in both groups. Pain was less often present after TREPP at 2 weeks and 6 months, but CPIP at rest at 1 year was comparable: 1.9% after TREPP vs 1.4% after TIPP, P = 0.535). The overall recurrence rate was higher in the TREPP group, 8.9% vs 4.6%, P = 0.022). Corrected for a learning curve for TREPP, no significant difference could be assessed (TREPP 5.7% and TIPP 4.8%, P = 0.591). CONCLUSION: Both the TREPP and TIPP technique resulted in a low incidence of CPIP after 1-year follow-up. The TREPP method can be considered a solid method for inguinal hernia repair if expertise is present. The learning curve of the TREPP techniques needs further evaluation. TRIAL REGISTRATION: ISRCTN18591339.
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Authors | Willem J V Bökkerink, Giel G Koning, Patrick W H E Vriens, Roland M H G Mollen, Mitchell J R Harker, Robin K Noordhof, Willem L Akkersdijk, Cees J H M van Laarhoven |
Journal | Annals of surgery
(Ann Surg)
Vol. 274
Issue 5
Pg. 698-704
(11 01 2021)
ISSN: 1528-1140 [Electronic] United States |
PMID | 34342299
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. |
Topics |
- Female
- Follow-Up Studies
- Hernia, Inguinal
(surgery)
- Herniorrhaphy
(methods)
- Humans
- Male
- Middle Aged
- Peritoneum
- Prospective Studies
- Single-Blind Method
- Surgical Mesh
- Treatment Outcome
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