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Ann Surg. 2016 May;263(5):862-6. doi: 10.1097/SLA.0000000000001579.

Long-term Results of a Randomized Double-blinded Prospective Trial of a Lightweight (Ultrapro) Versus a Heavyweight Mesh (Prolene) in Laparoscopic Total Extraperitoneal Inguinal Hernia Repair (TULP-trial).

Author information

1
*Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist, Utrecht, The Netherlands †Department of Surgery, UMCU Utrecht, Utrecht, The Netherlands ‡Department of Surgery, Heerlen, The Netherlands §Department of Geriatric Medicine, Diakonessenhuis Utrecht/Zeist, Utrecht, The Netherlands ¶Department of Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.

Abstract

OBJECTIVE:

The aim of the randomized clinical trial was to compare the 2 years of clinical outcomes of a lightweight (Ultrapro) vs a heavyweight (Prolene) mesh for laparoscopic total extraperitoneal (TEP) inguinal hernia repair.

BACKGROUND:

Lightweight meshes reduce postoperative pain and stiffness in open anterior inguinal hernia repair. The discussion about a similar benefit for laparoscopic repair is ongoing, but concerns exist about higher recurrence rates.

METHODS:

Between March 2010 and October 2012, male patients who presented with a primary, reducible unilateral inguinal hernia who underwent day-case TEP repair were eligible. Outcome parameters included chronic pain, recurrence, foreign body feeling, and quality of life scores.

RESULTS:

During the study period, 950 patients were included. One year postoperatively the presence of relevant pain (Numeric Rating Score 4-10) was significantly higher in the lightweight mesh group (2.9%) compared with the heavyweight mesh group (0.7%) (P = 0.01), and after 2 years this difference remained significant (P = 0.03). There were 4 (0.8%) recurrent hernias in the heavyweight mesh group and 13 (2.7%) in the lightweight group (P = 0.03). No differences in foreign body feeling or quality of life scores were detected.

CONCLUSIONS:

In TEP hernia surgery, there was no benefit of lightweight over heavyweight meshes observed 2 years postoperatively.

PMID:
26779980
DOI:
10.1097/SLA.0000000000001579
[Indexed for MEDLINE]

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