Fady Saleh1, Allan Okrainec1, Neil D'Souza2, Josephine Kwong2, Timothy D Jackson3. 1. Division of General Surgery, University Health Network, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada. 2. Department of Surgery, University of Toronto, Toronto, Ontario, Canada. 3. Division of General Surgery, University Health Network, Toronto, Ontario, Canada; Department of Surgery, University of Toronto, Toronto, Ontario, Canada. Electronic address: Timothy.Jackson@uhn.ca.
Abstract
BACKGROUND: Primary laparoscopic repair of unilateral inguinal hernias has not achieved widespread recognition mainly because of concerns over safety. METHODS: Prospective cohort study using the American College of Surgeons National Surgery Quality Improvement Program between 2005 and 2010. Complications in patients undergoing unilateral first-time, elective laparoscopic unilateral inguinal hernia repair (LIHR) were compared with open inguinal hernia repair (OIHR). RESULTS: Of 37,645 identified patients, 6,356 (16.9%) underwent LIHR and 31,289 (83.1%) underwent OIHR. Both groups had similar 30-day overall complications, major complications, and mortality rates: 62 (1.0%) vs 307 (1.0%), P = 1.00; 31 (.5%) vs 173 (.5%), P = .57; and 1 (.02%) vs 16 (.05%), P = .34, respectively. Using multivariable logistic regression, overall complications showed no difference, OR 1.01 (95% CI .76 to 1.34; P = .94), as did major complications, OR .90 (95% CI .61 to 1.34; P = .62), although favoring the LIHR group, where OR and CI represent the odss ratio and confidence intervals. CONCLUSION: These data demonstrate no significant difference between elective unilateral LIHR and OIHR with regard to 30-day morbidity and mortality.
BACKGROUND: Primary laparoscopic repair of unilateral inguinal hernias has not achieved widespread recognition mainly because of concerns over safety. METHODS: Prospective cohort study using the American College of Surgeons National Surgery Quality Improvement Program between 2005 and 2010. Complications in patients undergoing unilateral first-time, elective laparoscopic unilateral inguinal hernia repair (LIHR) were compared with open inguinal hernia repair (OIHR). RESULTS: Of 37,645 identified patients, 6,356 (16.9%) underwent LIHR and 31,289 (83.1%) underwent OIHR. Both groups had similar 30-day overall complications, major complications, and mortality rates: 62 (1.0%) vs 307 (1.0%), P = 1.00; 31 (.5%) vs 173 (.5%), P = .57; and 1 (.02%) vs 16 (.05%), P = .34, respectively. Using multivariable logistic regression, overall complications showed no difference, OR 1.01 (95% CI .76 to 1.34; P = .94), as did major complications, OR .90 (95% CI .61 to 1.34; P = .62), although favoring the LIHR group, where OR and CI represent the odss ratio and confidence intervals. CONCLUSION: These data demonstrate no significant difference between elective unilateral LIHR and OIHR with regard to 30-day morbidity and mortality.
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