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Could long-term follow-up modify the outcomes after laparoscopic TAPP? A 5-year retrospective cohort study

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Abstract

Purpose

Laparoscopic inguinal hernia repair (LIHR) has demonstrated multiple benefits. However, long-term results regarding recurrence and quality of life (QoL) are still on debate. We aimed to analyze postoperative outcomes with long-term follow-up after LIHR.

Methods

A consecutive series from December 2012 to May 2017 of laparoscopic TAPP was included. A minimum of 6 months of follow-up was required for inclusion. The sample was divided into two groups, G1: patients with recurrence and G2: patients without recurrence. Patient’s characteristics, operative variables and postoperative outcomes were analyzed. A QoL survey (Eura-HS QoL) was performed in the pre- and postoperative period.

Results

A total of 717 laparoscopic TAPP were performed in 443 patients. On univariate analysis, smoking, previous recurrence, mesh size smaller than 12 × 15 cm and surgical teams with less than 30 cases/year showed an increased recurrence rate (p < 0.05). But only smoking and less experienced teams were statistically significant on multivariate analysis (p < 0.01). After a 2-year follow-up, recurrence rate was 1.5%, while it increased to 2.6% (n = 19) at 5-year follow-up. Sixty percent of patients answered QoL survey. Average preoperative scores of pain, activities restriction and aesthetic dissatisfaction improved significantly after 6 months of follow-up in patients without recurrence.

Conclusions

After LIHR, quality of life shows a significant improvement in all parameters. Extending follow-up beyond 2 years after laparoscopic TAPP allows a more accurate assessment of recurrence rate. Smoking and inexperienced teams were significant risk factors for its development.

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Correspondence to E. E. Sadava.

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Conflict of interest

Drs. Peña, Dreifuss, Schlottmann and Sadava have no conflicts of interest or financial ties to disclosure.

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The Hospital Alemán of Buenos Aires Institutional Review Board reviewed and approved this study.

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The study including human participants has been performed in concordance with ethical standards of the Declaration of Helsinki and its later amendments.

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For this study, formal consent was not required.

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Peña, M.E., Dreifuss, N.H., Schlottmann, F. et al. Could long-term follow-up modify the outcomes after laparoscopic TAPP? A 5-year retrospective cohort study. Hernia 23, 693–698 (2019). https://doi.org/10.1007/s10029-019-01953-5

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  • DOI: https://doi.org/10.1007/s10029-019-01953-5

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