Low recurrence rate after laparoscopic (TEP) and open (Lichtenstein) XXXX : a randomized, multicenter trial with 5-year follow-up.

@entity1 @entity25288 @entity169 @entity282
OBJECTIVES: To compare a laparoscopic (totally extraperitoneal patch (TEP)) and an open technique (Lichtenstein) for @entity169 regarding recurrence rate and possible risk factors for recurrence. SUMMARY BACKGROUND DATA: Laparoscopic hernia repair has been introduced as an alternative to open repair. Short-term follow-up suggests benefits for those @entity1 operated with a laparoscopic approach compared with open techniques; ie, less @entity282 and a shorter convalescence period. Long-term results, however, are less well known. METHODS: The study was conducted as a multicenter randomized trial with a 5-year follow-up. A total of 1512 @entity1 aged 30 to 70 years, with a primary @entity169 , were randomized to either TEP or Lichtenstein repair. RESULTS: Overall, 665 @entity1 in the TEP group and 705 @entity1 in the Lichtenstein group were evaluable. The cumulative recurrence rate was 3.5% in the TEP group and 1.2% in the Lichtenstein group (P = 0.008). Test for heterogeneity revealed significant differences between individual surgeons. The exclusion of 1 surgeon, who was responsible for 33% (7 of 21) of all recurrences in the TEP group, lowered the cumulative recurrence rate to 2.4% in this group, which was not statistically different from that of the Lichtenstein group. CONCLUSIONS: The recurrence rate for both @entity25288 and Lichtenstein repair was low. A higher cumulative recurrence rate in the TEP group was seen at 5 years. Further analysis revealed that this could be attributable to incorrect surgical technique.
