Randomized controlled trial of laparoscopic transabdominal preperitoneal hernioplasty vs Shouldice repair - 5-year results

Background: There is a scarcity of data on long-term results after laparosc opic hernia repair. Herein we report on the outcome of a group of patients who were followed up for 5 years in a multicenter study on hernia repair. Methods: A total of 100 patients with 127 hernias were randomized to underg o either transabdominal preperitoneal (TAPP) or Shouldice hernia repair. Fo llow-up was by clinical examination and standardized questionnaire. Results: Of the 100 patients who underwent surgery, 84 were available for f ollow-up at 5 years. The TAPP procedure was less painful than the Shouldice repair, with fewer patients receiving narcotic analgesics. The median time to return to 100% activity was shorter in the laparoscopic group (21 days) than in the Shouldice group (40 days). Up to 60 months after the operation , the complication rate was lower in laparoscopically repaired hernias (19/ 66) than in the open group (25/61). There were two recurrences (3.9%) in th e TAPP group and five in the Shouldice group (10.2%). Conclusion: The TAPP hernia repair yields comparable or better results than Shouldice herniorrhaphy in terms of postoperative pain, recovery, and recu rrence rate.