Comparison of short- and long-term efficacy and economic indicators between transabdominal preperitoneal and open tension-free repair for inguinal hernia in adults: a meta-analysis of randomized controlled trials.

PURPOSE: The study aimed to compare the short- and long-term effects as well as economic indicators of transabdominal preperitoneal (TAPP) and open tension-free repair in the treatment of adult primary inguinal hernia.

METHODS

The study collected a database of clinical randomized controlled trials (RCTs), and was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

The operation time of TAPP in the treatment of unilateral inguinal hernia was higher than that in the open group, but there was no significant difference in the treatment time of bilateral inguinal hernia. There were significant differences between the two groups in acute visual analgesic scale (VAS) pain (1 day 2.35 ± 1.02 vs. 3.98 ± 1.43, 1 week 1.19 ± 1.1 vs. 2.41 ± 1.23, both p < 0.05) or chronic VAS pain (2% VS. 7%, p < 0.05), length of hospital stay (2.1 ± 1.6 vs. 2.4 ± 1.7 days, p < 0.05), wound infection (1% vs. 4%, p < 0.05), and time to return to work (12.58 ± 5.88 vs. 16.91 ± 5.46 days, p < 0.05). There was a difference in hospitalization cost between the two groups (1471.78 ± 236.57 vs. 986.55 ± 224.19 Euros, p < 0.05).

CONCLUSION

Compared with open tension-free repair, TAPP has the advantages of less pain, quicker recovery, shorter hospital stays, and lower incidence of wound infection. TAPP also has the drawback of longer surgical time and higher costs of hospitalization. Therefore, TAPP may be a preferable choice for privately insured patients with primary inguinal hernia.