Long term inguinal pain comparing TEP to Lichtenstein repair: the TEPLICH RCT 8 years follow-up.

IF 2.6 2区医学 Q1 SURGERY

Hernia Pub Date : 2024-12-19 DOI:10.1007/s10029-024-03246-y

A Gutlic, U Petersson, P Rogmark, A Montgomery

{"title":"Long term inguinal pain comparing TEP to Lichtenstein repair: the TEPLICH RCT 8 years follow-up.","authors":"A Gutlic, U Petersson, P Rogmark, A Montgomery","doi":"10.1007/s10029-024-03246-y","DOIUrl":null,"url":null,"abstract":"Purpose: To investigate long-term chronic postoperative inguinal pain (CPIP), QoL and recurrence in patients with a primary inguinal hernia comparing TEP to Lichtenstein.Material and methods: A questionnaire-based follow-up containing the Inguinal Pain Questionnaire (IPQ), the Cunningham Pain Scale and SF-36 was done 8 years after the TEPLICH RCT. The main objective was non-ignorable pain last week according to IPQ. A phone interview was performed with patients reporting new non-ignorable pain and those having a suspected recurrence. Records were scanned for long-term CPIP and recurrences. A lost to follow-up analysis was performed.Results: A total of 322 of 366 patients (88%) completed the follow-up of mean 7.94 years (5-10.75 years). Non-ignorable pain last week was reported by 7.6% in TEP and 6.7% in Lichtenstein (p < 0.73). New non-ignorable pain was reported by 5 patients. No difference in non-ignorable pain over time (1-8 years) was observed within groups. Moderate to severe pain, according to Cunningham, was reported by 3.8% in TEP and 5.5% in Lichtenstein (p < 0.48). QoL remained above the Swedish norm. No recurrences occurred after 3 years follow-up. The lost to follow-up analysis showed no difference in non-ignorable pain.Conclusions: RCTs, comparing TEP to Lichtenstein repair with follow-up ≥ 5 years regarding CPIP are sparse with conflicting data. In this study, low frequencies of CPIP present at 3 years seem to persist at 8 years. Recurrences occured within the first 3 years. Patients need to be informed of the risk of long-term CPIP.","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"49"},"PeriodicalIF":2.6000,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659355/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hernia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10029-024-03246-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To investigate long-term chronic postoperative inguinal pain (CPIP), QoL and recurrence in patients with a primary inguinal hernia comparing TEP to Lichtenstein.

Material and methods: A questionnaire-based follow-up containing the Inguinal Pain Questionnaire (IPQ), the Cunningham Pain Scale and SF-36 was done 8 years after the TEPLICH RCT. The main objective was non-ignorable pain last week according to IPQ. A phone interview was performed with patients reporting new non-ignorable pain and those having a suspected recurrence. Records were scanned for long-term CPIP and recurrences. A lost to follow-up analysis was performed.

Results: A total of 322 of 366 patients (88%) completed the follow-up of mean 7.94 years (5-10.75 years). Non-ignorable pain last week was reported by 7.6% in TEP and 6.7% in Lichtenstein (p < 0.73). New non-ignorable pain was reported by 5 patients. No difference in non-ignorable pain over time (1-8 years) was observed within groups. Moderate to severe pain, according to Cunningham, was reported by 3.8% in TEP and 5.5% in Lichtenstein (p < 0.48). QoL remained above the Swedish norm. No recurrences occurred after 3 years follow-up. The lost to follow-up analysis showed no difference in non-ignorable pain.

Conclusions: RCTs, comparing TEP to Lichtenstein repair with follow-up ≥ 5 years regarding CPIP are sparse with conflicting data. In this study, low frequencies of CPIP present at 3 years seem to persist at 8 years. Recurrences occured within the first 3 years. Patients need to be informed of the risk of long-term CPIP.

查看原文本刊更多论文

长期腹股沟疼痛比较TEP和Lichtenstein修复：TEPLICH RCT 8年随访。

目的：比较TEP与Lichtenstein对原发性腹股沟疝患者术后长期慢性疼痛（CPIP）、生活质量和复发的影响。材料与方法：在TEPLICH随机对照试验后8年进行问卷调查，包括腹股沟疼痛问卷（IPQ）、坎宁安疼痛量表（Cunningham Pain Scale）和SF-36。根据IPQ，上周的主要目标是不可忽视的痛苦。对报告新的不可忽视的疼痛和怀疑复发的患者进行电话采访。扫描长期CPIP和复发记录。进行了失访分析。结果：366例患者中322例（88%）完成了平均7.94年（5 ~ 10.75年）的随访。上周不可忽视的疼痛在TEP和Lichtenstein患者中分别为7.6%和6.7% (p)。结论：比较TEP和Lichtenstein修复与CPIP随访≥5年的随机对照试验很少，数据相互矛盾。在这项研究中，低频率的CPIP出现在3年似乎持续到8年。复发发生在前3年内。需要告知患者长期CPIP的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.