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Which is the best laparoscopic approach for inguinal hernia repair : TEP or TAPP? A systematic review of the literature with a network meta-analysis
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Bracale, Umberto, Melillo, Paolo, Pignata, Giusto, Salvo, Enrico, Rovani, Marcella, Merola, Giovanni and Pecchia, Leandro (2012) Which is the best laparoscopic approach for inguinal hernia repair : TEP or TAPP? A systematic review of the literature with a network meta-analysis. Surgical Endoscopy, Volume 26 (Number 12). pp. 3355-3366. doi:10.1007/s00464-012-2382-5 ISSN 0930-2794.
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Official URL: http://dx.doi.org/10.1007/s00464-012-2382-5
Abstract
Background
Totally extraperitoneal (TEP) repair and transabdominal preperitoneal (TAPP) repair are the most used laparoscopic techniques for inguinal hernia treatment. However, many studies have shown that laparoscopic hernia repair compared with open hernia repair (OHR) may offer less pain and shorter convalescence. Few studies compared the clinical efficacy between TEP and TAPP technique. The purpose of this study is to provide a comparison between TEP and TAPP for inguinal hernia repair to show the best approach.
Methods
We performed an indirect comparison between TEP and TAPP techniques by considering only randomized, controlled trials comparing TEP with OHR and TAPP with OHR in a network meta-analysis. We considered the following outcomes: operative time, postoperative complications, hospital stay, postoperative pain, time to return to work, and recurrences.
Results
The two techniques improved some short outcomes (such as time to return to work) with respect to OHR. In the network meta-analysis, TEP and TAPP were equivalent for operative time, postoperative complications, postoperative pain, time to return to work, and recurrences, whereas TAPP was associated with a slightly longer hospital stay compared with TEP.
Conclusions
TEP and TAPP improved clinical outcomes compared with OHR, but the network meta-analysis showed that TEP and TAPP efficacy is equivalent. TAPP was associated with a slightly longer hospital stay compared with TEP.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Engineering > Engineering | ||||
Journal or Publication Title: | Surgical Endoscopy | ||||
Publisher: | Springer New York LLC | ||||
ISSN: | 0930-2794 | ||||
Official Date: | 2012 | ||||
Dates: |
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Volume: | Volume 26 | ||||
Number: | Number 12 | ||||
Page Range: | pp. 3355-3366 | ||||
DOI: | 10.1007/s00464-012-2382-5 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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