LAPAROSCOPIC VERSUS OPEN INGUINAL HERNIORRHAPHY - PRELIMINARY-RESULTSOF A RANDOMIZED CONTROLLED TRIAL

Background. Benefits of laparoscopic herniorrhaphy (LH) over open hern ia repair (OH) remain unproved. Methods. Interim analysis of a prospec tive randomized controlled trial compared OH with LH where study outco mes were measured by third-party evaluators through patient interviews . Results. Both groups were well matched for all baseline parameters, although LH patients anticipated a quicker postoperative recovery than OH (p = 0.014). No significant difference was noted in operating time or surgeon operative satisfaction. The median duration of hospital st ay was I day in both groups; LH patients made use of significantly les s postoperative narcotics than OH (p = 0.02). No difference was observ ed in the durations of convalescence (LH, 9.6 +/- 7.6 days; OH, 10.9 /- 7.4 days). Greater improvements in quality of life were exhibited i n LH patients than OH patients I month after operation (p = 0.035), wi th one of the two measures used. A greater percentage of LH patients s eemed ''very satisfied with their operation'' (p = 0.07). Complication rates were similar and a single recurrence, in a patient in the OH gr oup, has been observed after a median follow-up of 14 months. Conclusi ons. Direct cost measurements showed LH to be 40% more expensive than OH in the context of a Canadian-type health care system. To date, bene fits in postoperative pain and possibly quality of life have been dete cted in the LH group.