Endoscopic totally extraperitoneal inguinal hernia repair versus open tension-free inguinal hernia repair for inguinal hernia

Objective The aim of this study was to compare the efficacy of endoscopic totally extraperitoneal (TEP) inguinal hernia repair and conventional open tension-free inguinal hernia repair in the treatment of inguinal hernias. Methods: Seventy-seven patients with unilateral inguinal hernias, admitted to the Department of General Surgery in Qingdao Center Hospital, between January 2016 and October 2017, were enrolled and randomly assigned to undergo endoscopic TEP inguinal hernia repair (endoscopic group, n=40) or conventional open tension-free inguinal hernia repair (conventional group, n=37). Operative duration, intraoperative bleeding, postoperative hospital stays, time to postoperative ambulation, total hospitalization costs, postoperative pain, and scores of quality of life at one month and three months, postoperatively, were recorded and compared. Results: Operation duration, intraoperative bleeding, postoperative hospital stays, and time to postoperative ambulation of patients were more greatly improved in the laparoscopic group than those in the conventional group (all P<0.05), though total hospitalization costs were higher in the laparoscopic group (P<0.05). Rate of postoperative 24-hour pain was lower in the laparoscopic group (P<0.05), however, rates of postoperative chronic pain and postoperative complications were generally similar (both P>0.05). Regarding postoperative quality of life, items including physiological functioning (PF), rolephysical (RP), social functioning (SF), role-emotional (RE), and bodily pain (BP) of patients, 1 month after surgery, were more greatly improved in the laparoscopic group (all P<0.05), as were items of PF, SF, and RE at 3 months (all P<0.05). Conclusion: Endoscopic TEP inguinal hernia repair is superior to conventional open tension-free inguinal hernia repair for management of inguinal hernias. Endoscopic TEP inguinal hernia repair resulted in more rapid postoperative recovery, shorter hospital stays, lower pain rate at 24 hours after surgery, and higher quality of life. Endoscopic repair is worthy of extensive clinical use though it is associated with higher hospitalization costs.