Open AccessSurgical outcomes of totally extraperitoneal repair for inguinal hernia: A retrospective multicenter propensity score‐matched study
Author(s) -
Takeuchi Yu,
Etoh Tsuyoshi,
Suzuki Kosuke,
Ohyama Tetsuji,
Hiratsuka Takahiro,
Ishio Tetsuya,
Kugimiya Mutsuhiro,
Matsumoto Toshifumi,
Kai Seiichiro,
Bandoh Toshio,
Shibata Kohei,
Iwaki Kentaro,
Tahara Kouichirou,
Shigemitsu Yuji,
Inomata Masafumi
Publication year - 2021
Publication title -
annals of gastroenterological surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.308
H-Index - 15
ISSN - 2475-0328
DOI - 10.1002/ags3.12443
Subject(s) - propensity score matching , medicine , inguinal hernia , retrospective cohort study , surgery , hernia repair , hernia , blood loss
Background Laparoscopic surgical approaches, including total extraperitoneal repair (TEP), have been widely accepted for inguinal hernia repair in Japan. However, there are limited data regarding recurrence after TEP in Japan, given the limited versatility of this procedure. This study retrospectively evaluated the rates of hernia recurrence after TEP and open mesh repair at multiple Japanese centers. Methods This retrospective study evaluated 1917 patients who underwent inguinal hernia repair at 32 institutions in the Oita prefecture between January 2014 and December 2015. Eligible patients were grouped according to whether they underwent TEP (1011 patients) or open mesh repair (636 patients). Propensity score matching was performed 1:1 (total: 1076 patients, 538 patients from each group). The outcomes of interest were recurrence, morbidity, and postoperative recovery. Results The TEP and open mesh repair groups had similar baseline characteristics. After propensity score matching, there was no significant difference between the two groups in terms of recurrence rate (TEP: 0.5% vs open mesh repair: 1.0%, P = .375). However, the TEP group had significantly longer operating times (median: 70.2 min vs 65.0 min, P < .001), significantly less blood loss (0‐5.1 mL vs 0–20.4 mL, P < .001), and significantly shorter postoperative hospital stays (median: 5.0 days vs 6.4 days, P < .001). The overall incidences of morbidity were 6.2% in the TEP group and 7.2% in the open mesh repair group (P = .535). Conclusion This multicenter retrospective study with propensity score matching revealed that the recurrence rates were similarly low for TEP and open mesh repair of inguinal hernia. Thus, a well‐trained surgical team could use TEP as a standard procedure.