Quality Of Life Following Laparoscopic Inguinal Hernia Repair Versus Open Mesh Repair

BACKGROUNDInguinal hernias are protrusions of abdominal cavity contents through the inguinal canal. They are very common .It is estimated that 5% - 10% of the population will develop an abdominal wall hernia. Inguinal hernias are more likely to occur in males than females. People who are obese, have lost a great deal of weight, or have had abdominal surgery are at higher risk for hernias. The risk also increases with age. Inguinal hernia repair (IHR) is the most frequently performed operation in general surgery. In the UK, approximately 70,000 surgical repairs of IHR are performed each year. In the United States, over 700,000 hernia repairs are carried out annually. Since 1980s, Laparoscopic surgery has developed quickly because of its small wound, little pain , fast recovery ,and short hospital stays . There has been a shift towards laparoscopic techniques to repair the defect. Laparoscopic Inguinal Hernia Repair(LIHR) became an useful method to treat the Inguinal Hernia. In the past, the recurrence rate was a major outcome measure in IHR studies. However, new surgical techniques have meant that the recurrence rate has dropped substantially. Consequently, outcome measures have shifted focus to adverse outcomes of IHR. Chronic pain following surgery has emerged as a common and sometimes severe problem that can significantly affect patient health-related quality of life (HRQL). According to many studies, LIHR can significantly improve the patients' quality of life, when compared to tension-free hernioplasty. This study aims to assess the quality of life following Laparoscopic Inguinal Hernia Repair and tension-free hernioplasty by using instrument of VAS scale and SF-36 scores.METHODS52 patients have been prospectively studied.26 patients each group. One group underwent a Laparoscopic Inguinal Hernia Repair. The other group underwent a tension-free hernioplasty . Quality of life was measured by the instrument of VAS scale and SF-36 scores. The patients received the questionnaire after surgery .The improvement concerned the pain relief after surgery and life satisfaction.RESULTTwo groups of patients had no recurrence. One week after surgery, more patients in the open group (88.5%) than in the laparoscopic group (80.7%) Suffered from pain. At 3 months, 15.4% of patients underwent a LIHR reported some sort of pain as measured by the VAS. And 19.2% of patients underwent a tension-free hernioplasty reported chronic pain.At 1 month, there was a greater improvement in mean SF-36 scores in the laparoscopic group compared with the open group on seven of eight dimensions, reaching significance on four. For every activity considered the median time until return to normal was significantly shorter for the laparoscopic group.Patients from the group underwent a laparoscopic inguinal hernia repair were more satisfied with surgery than the open group at 3 months after surgery.CONCLUSIONSThis study confirms that laparoscopic hernia repair has considerable clinical advantages after discharge compared with open mesh hernioplasty .The VAS scale and SF-36 scores are sensitive tools to assess surgical outcomes after inguinal hernia repair.