Format

Send to

Choose Destination
Surg Endosc. 2015 Dec;29(12):3750-60. doi: 10.1007/s00464-015-4150-9. Epub 2015 Mar 25.

TEP versus TAPP: comparison of the perioperative outcome in 17,587 patients with a primary unilateral inguinal hernia.

Author information

1
Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstraße 6, 13585, Berlin, Germany. ferdinand.koeckerling@vivantes.de.
2
Hernia Center, Winghofer Medicum, Winghofer Straße 42, 72108, Rottenburg am Neckar, Germany.
3
Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstraße 6, 13585, Berlin, Germany.
4
StatConsult GmbH, Halberstädter Straße 40 a, 39112, Magdeburg, Germany.
5
Department of General and Visceral Surgery, Diakonie Hospital, Rosenbergstraße 38, 70176, Stuttgart, Germany.
6
Department of General and Visceral Surgery, German Red Cross Hospital, Lützerodestraße 1, 30161, Hannover, Germany.

Abstract

INTRODUCTION:

More than 20 years since the introduction of TAPP and TEP into clinical routine, there is a lack of clarity due to conflicting comparative data. Therefore, more results from registries are needed.

PATIENTS AND METHODS:

A total of 17,587 patients were enrolled prospectively between September 1, 2009, and April 15, 2013, in the Herniamed registry. Of these patients, 10,887 (61.9%) had a TAPP and 6700 (38.1%) a TEP repair. The dependent variables were intra- and postoperative complication rates, number of reoperations as well as absolute and relative frequencies. The results of unadjusted analyses were verified via multivariable analyses.

RESULTS:

Multivariable analysis verified the results of unadjusted analysis, indicating that the surgical technique did not have any significant impact, also while taking account of other factors, on occurrence of intraoperative [p = 0.1648; OR = 1.214 (0.923; 1.596)] and general postoperative complications [p = 0.0738; OR = 1.315 (0.974; 1.775)]. Postoperative surgical complications [OR = 2.323 (1.882; 2.866); p < 0.0001] were noted more often after TAPP. Furthermore, the hernia defect size [p < 0.0001; I vs III: OR = 0.439 (0.313; 0.615), II vs III: OR = 0.712 (0.582; 0.872)] or scrotal [p < 0.0001; OR = 2.170 (1.501; 3.137)] hernia and age [p = 0.0002; 10-year OR = 1.135 (1.062; 1.213)] had a significant impact on the occurrence of postoperative complications. Complications were observed more commonly for larger hernia defects and a scrotal hernia. However, the difference in the postoperative complication rate between TEP and TAPP did not result in any difference in the reoperation rate (TEP 0.82% vs TAPP 0.90%; p = 0.6165).

CONCLUSION:

The intraoperative and general postoperative complication rates as well as the reoperation rate for complications show no significant difference between TEP and TAPP. The higher postoperative complication rate for TAPP, which could be managed conservatively, is partly explained by larger defect sizes, more scrotal hernias and older age.

KEYWORDS:

Inguinal hernia repair; Intraoperative complications; Postoperative complications; Seroma; TAPP; TEP

PMID:
25805239
PMCID:
PMC4648956
DOI:
10.1007/s00464-015-4150-9
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center