A Prospective Nonrandomized Study of Comparison of Perioperative and Quality of Life Outcomes of Endoscopic Versus Open Inguinal Hernia Repair: Data from a Developing Country.

ABSTRACT

OBJECTIVES: To determine the perioperative outcomes and quality of life (QOL) following endoscopic inguinal hernia repair (EIH) versus open inguinal hernia repair (OIH) using the hernia-specific Carolinas Comfort Scale® (CCS) questionnaire. MATERIALS AND METHODS: A prospective nonrandomized study from September 2014 to August 2015 included all patients who underwent elective primary endoscopic (totally extraperitoneal repair/transabdominal preperitoneal) or OIH. Baseline patient characteristics were recorded in addition to mean operating time, intraoperative and postoperative complications, return to work, and QOL. RESULTS: Mean operative duration was significantly longer in EIH compared with OIH (102.5 ± 11.9 minutes versus 66.9 ± 12.7 minutes, P = .001). Mean duration of hospital stay (5.7 ± 1.3 days versus 2.6 ± 0.6 days, P = .001), time to return to routine work (5.8 ± 1.1 days versus 3.7 ± 0.8 days, P = .001), and return to office work (OIH versus EIH 12.3 ± 1.9 days versus 7.6 ± 0.8 days, P = .001) were significantly shorter in EIH. Intraoperative and postoperative complications were comparable in both the groups, except for surgical site infection, which was more with OIH (20.3% versus 5.6%, P = .04), and postoperative pain scores, which were reduced in EIH. QOL was better in EIH with a significant decrease in terms of sensation of mesh, postoperative pain, and movement limitation. CONCLUSIONS: Endoscopic hernia repair offers reduced hospital stay, equivocal perioperative complications, reduced postoperative pain, and early return to normal activity and work. This assumes importance in developing countries as most of the patients are the sole earning member in the family. QOL is also significantly improved with endoscopic repair with a considerable change for better with time.