Long-term results of a randomized clinical trial between laparoscopic hernioplasty and Shouldice repair

Background: At present only short-term follow-up data are available to comp are endoscopic and conventional hernia surgery. This paper presents data fr om a randomized study 6 years after initial recruitment. Methods: In 1993 a randomized comparative study of transabdominal preperito neal (TAPP) and Shouldice repair was commenced. Endpoints were rate of recu rrence, late complications, complaints and patient satisfaction. Results: The rate of recurrence in the TAPP group was one (2 per cent) of 4 8 patients and in the Shouldice group two (5 per cent) of 43. Only five pat ients in the Shouldice and three in the TAPP group reported slight discomfo rt in the inguinal region at 6-year follow-up. In neither group was chronic pain syndrome observed. Altogether, 46 (96 per cent) of 48 patients in the TAPP group and 35 (81 per cent) of 43 of those having the Shouldice proced ure stated complete satisfaction with the hernia repair. Conclusion: Long-term evaluation demonstrated greater satisfaction with the result of the repair in the endoscopic group. The difference between the g roups in the recurrence rate was not significant, because of the small numb ers. The TAPP method appears to be an effective surgical alternative in pat ients with inguinal hernia.