Safety of two common laparoscopic inguinal herniorrhaphy approaches: An updated systematic review with meta-analysis of randomized clinical trials

Tsung Yu Hung, Chien Chih Wu, Li Siou Chen, Yi No Kang

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Previous evidence indicated that total extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) are advantageous in efficacy of inguinal herniorrhaphy. Therefore, our aim in this study was to evaluate the association of the two laparoscopic approaches on safety of inguinal herniorrhaphy. Methods: In this update study, we searched the Cochrane Library, EMBASE, PubMed, Scopus, and Web of Science and identified randomized clinical trials comparing complications in TEP and TAPP herniorrhaphy. We mainly used Peto odds ratio with 95% confidence interval (CI) for meta-analysis because of zero-cell. Results: Fourteen eligible trials recruited 659 and 682 patients in TEP and TAPP respectively. In overall pooling, although TEP had a higher seroma rate than TAPP (Peto odds ratio =2.01; 95% CI, 1.39 to 2.91), it had a lower scrotal/cord edema rates at immediate postoperative (Peto odds ratio =0.22; 95% CI, 0.09 to 0.57) and 1 week after inguinal hernia repair (Peto odds ratio =0.58; 95% CI, 0.37 to 0.91) than TAPP. Conclusions: TEP and TAPP have their own advantages in inguinal herniorrhaphy. TAPP was associated with a lower seroma rate, and TEP was associated with a lower edema rate. Therefore, shared decision-making on laparoscopic inguinal herniorrhaphy with TEP and TAPP is still needed.

Original languageEnglish
Pages (from-to)2007-2021
Number of pages15
JournalTranslational Andrology and Urology
Volume9
Issue number5
DOIs
Publication statusPublished - Oct 2020

Keywords

  • Inguinal hernia
  • Laparoscopic herniorrhaphy
  • Totally extraperitoneal (TEP)
  • Transabdominal preperitoneal (TAPP)

ASJC Scopus subject areas

  • Reproductive Medicine
  • Urology

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