Surgery · 2026
Laparoscopic transabdominal preperitoneal (TAPP) versus open Lichtenstein primary unilateral inguinal hernia repair: A systematic review and meta-analysis of randomized controlled trials.
СтатьяСистематический обзорМетаанализСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Butt Adam Umair Ashraf, Rehman Abdur, Iftikhar Taha, Zaied Mohammad A, Daniel Jeremiah, Farooq Talha, Ansab Muhammad, Mukhlis Muhammad, Khan Afsheen, Hamza Muhammad, Shweliya Mohammedsadeq A
Аннотация
BACKGROUND: Laparoscopic transabdominal preperitoneal and open Lichtenstein repairs are established techniques for primary unilateral inguinal hernia, yet prior studies have reported differing conclusions regarding several key outcomes.
OBJECTIVE: To compare perioperative and long-term outcomes between laparoscopic transabdominal preperitoneal and open Lichtenstein repair for primary unilateral inguinal hernias using data from randomized controlled trials.
METHODS: A systematic review and meta-analysis was conducted, comparing primary unilateral inguinal hernia repair using either laparoscopic transabdominal preperitoneal or Lichtenstein repair in adults. Random-effects models were used to estimate pooled mean differences and risk ratios with 95% confidence intervals. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool.
RESULTS: Seventeen studies were included. Transabdominal preperitoneal repair resulted in significantly lower postoperative pain on day 0 (mean difference = -1.75, 95% CI -2.48 to -1.01), day 1 (mean difference = -0.72, 95% CI -1.37 to -0.07), and week 1 (mean difference = -1.14, 95% CI -1.76 to -0.52). Compared with Lichtenstein repair, TAPP was associated with reduced risks of surgical site infection (risk ratio = 0.36, 95% CI 0.17-0.76), hematoma (risk ratio = 0.27, 95% CI 0.14-0.52), chronic pain (risk ratio = 0.42, 95% CI 0.20-0.88), and short-term recurrence (risk ratio = 0.26, 95% CI 0.08-0.90). No significant differences were observed in return to normal activity, hospital stay, or long-term recurrence.
CONCLUSION: Among adults undergoing primary unilateral inguinal hernia repair, transabdominal preperitoneal repair provides superior early outcomes and reduced chronic pain without increasing long-term recurrence, reinforcing its role as an effective minimally invasive option.
OBJECTIVE: To compare perioperative and long-term outcomes between laparoscopic transabdominal preperitoneal and open Lichtenstein repair for primary unilateral inguinal hernias using data from randomized controlled trials.
METHODS: A systematic review and meta-analysis was conducted, comparing primary unilateral inguinal hernia repair using either laparoscopic transabdominal preperitoneal or Lichtenstein repair in adults. Random-effects models were used to estimate pooled mean differences and risk ratios with 95% confidence intervals. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool.
RESULTS: Seventeen studies were included. Transabdominal preperitoneal repair resulted in significantly lower postoperative pain on day 0 (mean difference = -1.75, 95% CI -2.48 to -1.01), day 1 (mean difference = -0.72, 95% CI -1.37 to -0.07), and week 1 (mean difference = -1.14, 95% CI -1.76 to -0.52). Compared with Lichtenstein repair, TAPP was associated with reduced risks of surgical site infection (risk ratio = 0.36, 95% CI 0.17-0.76), hematoma (risk ratio = 0.27, 95% CI 0.14-0.52), chronic pain (risk ratio = 0.42, 95% CI 0.20-0.88), and short-term recurrence (risk ratio = 0.26, 95% CI 0.08-0.90). No significant differences were observed in return to normal activity, hospital stay, or long-term recurrence.
CONCLUSION: Among adults undergoing primary unilateral inguinal hernia repair, transabdominal preperitoneal repair provides superior early outcomes and reduced chronic pain without increasing long-term recurrence, reinforcing its role as an effective minimally invasive option.