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Articole multimedia Jurnalul de Chirurgie, Iasi, 2007, Vol. 3, Nr. 2 [ISSN 1584 – 9341]Specific trials: Fleming et al. Austr](BJS, 2001)-------------------------Shouldice (n=115) vs TEP (n=117)-------------------------------------------Endpoints were:-operation time (56 vs 70 min)-hospital stay (1-day:48 vs 68%)-sick leave (30 vs 14 days)- resumption of normal activities ( 35 vs 21 days)-costs (40% cheaper vs TEP)-complications at 1 year (9 vs 21%)Specific trials: Champault et al.[Fr](J.Chir.,1996)--------------------Stoppa (n= 49) vs TEP (n= 51)------------------------------------Endpoints were:- operation time (identical for unilateral;shorter for bilateral Stoppa)- hospital stay ( 7.3 vs 3.2 days)- sick leave (35 vs 17 days),- postop. pain ( less in TEP)- recurrence (6% vs 2%)Specific trials: Wara et al.[De](BJS, 2005)-------------------Lichtenstein (n=39537) vs. TAPP (n=3606)-----------------------------------------------------Endpoint: recurrence in various hernia categoriesprimary indirect: 1.0 % vs 0 %primary direct: 3.1 % vs 1.1%primary bilateral: 3.0 % vs 4.8 %recurrent unilateral: 4.8 % vs 4.6 %recurrent bilateral: 7.6 % vs 2.6 %Specific trials: Eklund et al.[S]( BJS, 2006)------------------------Lichtenstein (n=706) vs TEP (n= 665)----------------------------------------------Endpoints were postop.pain, period of sick leave,and resumption of normal activities:ALL 3 were in favour of TEP (p
Articole multimedia Jurnalul de Chirurgie, Iasi, 2007, Vol. 3, Nr. 2 [ISSN 1584 – 9341]Conclusions----------------------• 1. Open non-mesh repairs should be avoided• 2. Lichtenstein mesh repair : best open technique• 3. Laparoscopic techniques (TAPP &TEP) induce-less pain, shorter hospital stay, earlier return towork, more rapid resumption of activities andlower recurrence rates,-but at a higher cost, specially in non-’working’population184
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