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Prospective, randomized-controlled trial comparing postoperative pain after plug and patch open repair with totally extraperitoneal inguinal hernia repair

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Abstract

Purpose

The aim of this study was to compare postoperative pain between the open tension-free plug and patch (PP) technique and the totally extraperitoneal patch (TEP) hernioplasty.

Methods

One hundred and fifty-four male patients with unilateral inguinal hernia were randomized to undergo PP and TEP from 2005 to 2009. Pain assessment was conducted using the numerical rating scale (NRS) and the McGill Pain Questionnaire preoperatively, 6, 12 and 24 months postoperatively. All patients received the same analgesic regimen and documented pain in a NRS-based 4-week diary.

Results

Of the 154 patients 77 underwent TEP and 77 PP. Median follow-up was 3.8 years. One recurrent hernia was observed in the TEP and two in the PP group (p = 0.56). Median preoperative NRS scores were 2 and 2, 0.3 and 0.4 at 6 months, 0.1 and 0.3 at 12 months, 0.2 and 0.1 at 24 months postoperatively in the PP and TEP groups, respectively (p > 0.05). Data from the 4-week pain diaries revealed significant differences in pain intensity between the two different techniques from the second postoperative week (p < 0.05). Patients in the PP group required more additional analgesics on day four and five postoperatively (p = 0.037 and 0.015, respectively).

Conclusions

Our data favor the TEP technique concerning postoperative pain as primary endpoint between tension-free PP and TEP hernia repair.

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Conflict of interest

FA, FA, CK, AS, HU, JP and TS declare no conflict of interest.

Ethical standard

The authors declare that the trial complies with the current laws of Austria.

Author information

Authors and Affiliations

  1. Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    F. Aigner, F. Augustin, C. Kaufmann, J. Pratschke & T. Schmid

  2. Department of Anaesthesiology and Intensive Care, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria

    A. Schlager

  3. Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Schoepfstrasse 41/1, 6020, Innsbruck, Austria

    H. Ulmer

Authors
  1. F. Aigner
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  2. F. Augustin
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  3. C. Kaufmann
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  4. A. Schlager
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  5. H. Ulmer
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  6. J. Pratschke
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  7. T. Schmid
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Corresponding author

Correspondence to F. Aigner.

Additional information

F. Aigner and F. Augustin shared first authorship.

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Aigner, F., Augustin, F., Kaufmann, C. et al. Prospective, randomized-controlled trial comparing postoperative pain after plug and patch open repair with totally extraperitoneal inguinal hernia repair. Hernia 18, 237–242 (2014). https://doi.org/10.1007/s10029-013-1123-6

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  • DOI: https://doi.org/10.1007/s10029-013-1123-6

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