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Laparoscopic versus open inguinal hernia repair: randomised prospective trial
Laparoscopic surgery benefits patients because it reduces pain and enables earlier mobilisation. There is concern that laparoscopic hernia repair may enter surgical practice without proper evaluation. We have done a randomised, prospective study comparing laparoscopic and open inguinal hernia repair...
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Published in: | The Lancet (British edition) 1994-05, Vol.343 (8908), p.1243-1245 |
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description | Laparoscopic surgery benefits patients because it reduces pain and enables earlier mobilisation. There is concern that laparoscopic hernia repair may enter surgical practice without proper evaluation. We have done a randomised, prospective study comparing laparoscopic and open inguinal hernia repair performed under day-case general anaesthesia. 150 patients were randomised to have laparoscopic (group L) or open (group O) herniorrhaphy. Group L underwent transabdominal stapling of preperitoneal Prolene mesh. Group 0 underwent open repair, with a tension-free nylon darn. Postoperatively patients completed pain analogue scales eight times over 7 days, and use of analgesia was recorded. Time of return to normal domestic activity and to work was assessed. The groups were similar in age, sex, and body surface area. Self-administered co-proxamol was a median of 18 tablets (1 tablet=325 mg) in group O (n = 75) and 6 in group L (n = 75, p < 0·001). Overall mean pain analogue score was 3·1 (SD1·8, n = 70) in group O and 1·8 (SD 1·1, n=71) in group L (p |
doi_str_mv | 10.1016/S0140-6736(94)92148-2 |
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There is concern that laparoscopic hernia repair may enter surgical practice without proper evaluation. We have done a randomised, prospective study comparing laparoscopic and open inguinal hernia repair performed under day-case general anaesthesia. 150 patients were randomised to have laparoscopic (group L) or open (group O) herniorrhaphy. Group L underwent transabdominal stapling of preperitoneal Prolene mesh. Group 0 underwent open repair, with a tension-free nylon darn. Postoperatively patients completed pain analogue scales eight times over 7 days, and use of analgesia was recorded. Time of return to normal domestic activity and to work was assessed. The groups were similar in age, sex, and body surface area. Self-administered co-proxamol was a median of 18 tablets (1 tablet=325 mg) in group O (n = 75) and 6 in group L (n = 75, p < 0·001). Overall mean pain analogue score was 3·1 (SD1·8, n = 70) in group O and 1·8 (SD 1·1, n=71) in group L (p<0·0001). Return to normal domestic activity was a median of 7 days in group O (n= 72) and 3 days in group L (n=73) (p<0·001). Return to work was a median of 28 days in group O (n=39) and 14 days in group L (n=40) (p<0·002). These data suggest that laparoscopic hernia repair induces less pain than open hernia repair, and enables patients to return to normal activity and work more quickly.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(94)92148-2</identifier><identifier>PMID: 7910272</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Abdomen ; Adult ; Aged ; Analgesia ; Analgesics - administration & dosage ; Anesthesia ; Biological and medical sciences ; Evidence-based medicine ; Female ; Hernia ; Hernia, Inguinal - surgery ; Hernias ; Humans ; Laparoscopy ; Laparoscopy - methods ; Length of Stay ; Male ; Medical disorders ; Medical research ; Medical sciences ; Middle Aged ; Pain ; Pain Measurement ; Pain perception ; Pain, Postoperative ; Patients ; Postoperative Complications ; Prospective Studies ; Randomization ; Surgery ; Surgery (general aspects). 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May 21, 1994</rights><rights>Copyright Elsevier Limited May 21, 1994</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-4f686f5a5863c87f5ea776637f44ca6d41ad007ddc48a292c7cd8522f25d58d33</citedby><cites>FETCH-LOGICAL-c444t-4f686f5a5863c87f5ea776637f44ca6d41ad007ddc48a292c7cd8522f25d58d33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4054768$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7910272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stoker, D.L.</creatorcontrib><creatorcontrib>Spiegelhalter, D.J.</creatorcontrib><creatorcontrib>Singh, R.</creatorcontrib><creatorcontrib>Wellwood, J.M.</creatorcontrib><title>Laparoscopic versus open inguinal hernia repair: randomised prospective trial</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Laparoscopic surgery benefits patients because it reduces pain and enables earlier mobilisation. There is concern that laparoscopic hernia repair may enter surgical practice without proper evaluation. We have done a randomised, prospective study comparing laparoscopic and open inguinal hernia repair performed under day-case general anaesthesia. 150 patients were randomised to have laparoscopic (group L) or open (group O) herniorrhaphy. Group L underwent transabdominal stapling of preperitoneal Prolene mesh. Group 0 underwent open repair, with a tension-free nylon darn. Postoperatively patients completed pain analogue scales eight times over 7 days, and use of analgesia was recorded. Time of return to normal domestic activity and to work was assessed. The groups were similar in age, sex, and body surface area. Self-administered co-proxamol was a median of 18 tablets (1 tablet=325 mg) in group O (n = 75) and 6 in group L (n = 75, p < 0·001). Overall mean pain analogue score was 3·1 (SD1·8, n = 70) in group O and 1·8 (SD 1·1, n=71) in group L (p<0·0001). Return to normal domestic activity was a median of 7 days in group O (n= 72) and 3 days in group L (n=73) (p<0·001). Return to work was a median of 28 days in group O (n=39) and 14 days in group L (n=40) (p<0·002). These data suggest that laparoscopic hernia repair induces less pain than open hernia repair, and enables patients to return to normal activity and work more quickly.</description><subject>Abdomen</subject><subject>Adult</subject><subject>Aged</subject><subject>Analgesia</subject><subject>Analgesics - administration & dosage</subject><subject>Anesthesia</subject><subject>Biological and medical sciences</subject><subject>Evidence-based medicine</subject><subject>Female</subject><subject>Hernia</subject><subject>Hernia, Inguinal - surgery</subject><subject>Hernias</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical disorders</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pain</subject><subject>Pain Measurement</subject><subject>Pain perception</subject><subject>Pain, Postoperative</subject><subject>Patients</subject><subject>Postoperative Complications</subject><subject>Prospective Studies</subject><subject>Randomization</subject><subject>Surgery</subject><subject>Surgery (general aspects). 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Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stoker, D.L.</au><au>Spiegelhalter, D.J.</au><au>Singh, R.</au><au>Wellwood, J.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic versus open inguinal hernia repair: randomised prospective trial</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>1994-05-21</date><risdate>1994</risdate><volume>343</volume><issue>8908</issue><spage>1243</spage><epage>1245</epage><pages>1243-1245</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Laparoscopic surgery benefits patients because it reduces pain and enables earlier mobilisation. There is concern that laparoscopic hernia repair may enter surgical practice without proper evaluation. We have done a randomised, prospective study comparing laparoscopic and open inguinal hernia repair performed under day-case general anaesthesia. 150 patients were randomised to have laparoscopic (group L) or open (group O) herniorrhaphy. Group L underwent transabdominal stapling of preperitoneal Prolene mesh. Group 0 underwent open repair, with a tension-free nylon darn. Postoperatively patients completed pain analogue scales eight times over 7 days, and use of analgesia was recorded. Time of return to normal domestic activity and to work was assessed. The groups were similar in age, sex, and body surface area. Self-administered co-proxamol was a median of 18 tablets (1 tablet=325 mg) in group O (n = 75) and 6 in group L (n = 75, p < 0·001). Overall mean pain analogue score was 3·1 (SD1·8, n = 70) in group O and 1·8 (SD 1·1, n=71) in group L (p<0·0001). Return to normal domestic activity was a median of 7 days in group O (n= 72) and 3 days in group L (n=73) (p<0·001). Return to work was a median of 28 days in group O (n=39) and 14 days in group L (n=40) (p<0·002). These data suggest that laparoscopic hernia repair induces less pain than open hernia repair, and enables patients to return to normal activity and work more quickly.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>7910272</pmid><doi>10.1016/S0140-6736(94)92148-2</doi><tpages>3</tpages></addata></record> |
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subjects | Abdomen Adult Aged Analgesia Analgesics - administration & dosage Anesthesia Biological and medical sciences Evidence-based medicine Female Hernia Hernia, Inguinal - surgery Hernias Humans Laparoscopy Laparoscopy - methods Length of Stay Male Medical disorders Medical research Medical sciences Middle Aged Pain Pain Measurement Pain perception Pain, Postoperative Patients Postoperative Complications Prospective Studies Randomization Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Tablets Time Factors Treatment Outcome |
title | Laparoscopic versus open inguinal hernia repair: randomised prospective trial |
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