30738
document
Long-term results of a randomized clinical trial of Shouldice , Lichtenstein and transabdominal preperitoneal hernia repairs . INTRODUCTION There is an ongoing debate about the preferred technique for inguinal hernia repair . In this randomized study the long-term results of Shouldice , Lichtenstein and transabdominal preperitoneal ( TAPP ) hernia repair were compared . METHODS Some 280 men with a primary hernia were randomized prospectively to undergo Shouldice , tension-free Lichtenstein or laparoscopic TAPP repair . Patients were examined after 52 months to assess hernia recurrence , nerve damage , testicular atrophy and patient satisfaction . RESULTS Hernia recurrence occurred in six patients after Shouldice repair , and in one patient each after Lichtenstein and TAPP repairs . All recurrences after tension-free repairs were diagnosed within the first year after surgery . Nerve injuries were significantly more frequent after open Shouldice and Lichtenstein repairs . Patient satisfaction was greatest after laparoscopic TAPP repair . CONCLUSION Tension-free repair was superior to the non-mesh Shouldice technique . The open anterior approach to the groin was associated with demonstrable nerve injury , and laparoscopic TAPP repair was the most effective approach in the hands of an experienced surgeon .
30739
Intervention_Surgical
transabdominal preperitoneal hernia repairs
30740
Intervention_Surgical
transabdominal preperitoneal ( TAPP ) hernia repair
30741
Intervention_Surgical
laparoscopic TAPP repair
30742
Outcome_Physical
hernia recurrence
30743
Outcome_Physical
nerve damage
30744
Outcome_Physical
testicular atrophy
30745
Outcome_Other
patient satisfaction
30746
Outcome_Physical
Hernia recurrence
30747
Outcome_Physical
Nerve injuries
30748
Outcome_Other
Patient satisfaction
30749
Outcome_Physical
nerve injury
30750
Participant_Condition
Shouldice , Lichtenstein and transabdominal preperitoneal hernia
30751
Participant_Sample-size
280
30752
Participant_Sex
men
30753
Participant_Condition
primary hernia