Comparison of open and laparoscopic preperitoneal tension-free repair of groin hernia: a prospective nonrandomized controlled study.

BACKGROUND

This study aimed to compare the results of open and laparoscopic preperitoneal groin hernia repair.

METHODS

This study included patients with groin hernias who underwent open or laparoscopic preperitoneal herniorrhaphy in our department from October 2016 to December 2019 following the inclusion and exclusion criteria. Baseline characteristics, operative variables, recurrence, intraoperative, short-term, and long-term postoperative complications were recorded and further analyzed.

RESULTS

Among the 1251 patients (290 open and 948 laparoscopic, 13 bilateral hernias found during laparoscopic operation were withdrawn), 94.83% completed a median follow-up of 23 (8-52) months. The overall recurrence rate was 0.60%, and no significant difference was observed between the two approaches (p = 0.775). The overall complication rate of the laparoscopic approach was lower than that of the open approach (9.60 vs. 13.79%, p = 0.042), whereas the life-threatening complication rates were similar (1.38 vs. 0.63%, p = 0.214). The operation time was similar between the two approaches, but the laparoscopic approach resulted in significantly lower incidence rates of wound infection and chronic pain, lower visual analog scale scores, and faster recovery than the open approach, but the hospitalization cost was higher. After a propensity score-matched (PSM) analysis, postoperative chronic pain was proved no significant difference between the two groups.

CONCLUSIONS

Both open and laparoscopic procedures are safe and effective for groin hernia preperitoneal herniorrhaphy, with low incidence rates of life-threatening complications and recurrence. The laparoscopic approach is superior in terms of lower incidence rates of infection and faster recovery but costs more than the open approach.