scholarly journals Inguinal hernia repair in preterm neonates: is there evidence that spinal or general anaesthesia is the better option regarding intraoperative and postoperative complications? A systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028728 ◽  
Author(s):  
Katharina Dohms ◽  
Marc Hein ◽  
Rolf Rossaint ◽  
Mark Coburn ◽  
Christian Stoppe ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
Hospital Stay ◽  
General Anaesthesia ◽  
Inguinal Hernia Repair ◽  
Outcome Measures ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Duration Of Surgery

ObjectivesWhether spinal anaesthesia (SA) reduces intraoperative and postoperative complications compared with general anaesthesia (GA) was investigated.DesignThe meta-analysis was structured based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Databases (PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science) were searched, and four randomised controlled trials (RCTs) and two retrospective cohort studies were included. A random-effects model with pooled risk ratios and mean differences with 95% CIs were used. Statistical heterogeneity was evaluated using the I2statistic. Quality assessment of the studies was performed by assessing the risk of bias according to the Cochrane and GRADE methodology.SettingPublications from January 1990 to November 2018 were included.Participants and interventionsOur study selection captured information from studies focusing on neonates born before the 37th gestational week who were scheduled for an inguinal hernia repair operation under either SA or GA.Primary and secondary outcome measuresThe primary outcome measures were apnoea, postoperative ventilation and method failure rates according to predefined eligibility criteria. The duration of surgery, desaturation events <80%, hospital stay duration and postoperative bradycardia were secondary outcomes.ResultsWe found significantly fewer events for the outcomes ‘any episode of apnoea’ and ‘mechanical ventilation postoperatively’ in the SA group. Bradycardias were significantly less common in the SA group. In total, 7.5% of the SA group were converted to GA. The duration of surgery was significantly shorter in the SA group. No significant differences were found in the outcome measures ‘postoperative oxygen supplementation’, ‘prolonged apnoea’, ‘postoperative oxygen desaturation <80%’ and ‘hospital stay’.ConclusionsWe consider SA a convenient alternative for hernia repair in preterm infants, providing more safety regarding postoperative apnoea. To the best of our knowledge, this is the first meta-analysis to include studies exclusively comparing SA versus GA. More high-quality RCTs are needed.Trial registration numberCRD42016048683

scholarly journals Laparoscopic inguinal hernia repairs: comparison between TAPP and TEP at a tertiary center of Nepal

2018 ◽  
Vol 5 (11) ◽  
pp. 3719
Author(s):  
Komal B. Gurung ◽  
Niroj Banepali ◽  
Rakesh R. Sthapit ◽  
Baikuntha Adhikari
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Tep Repair ◽  
Laparoscopic Inguinal Hernia ◽  
Inguinal Hernias ◽  
Tertiary Center ◽  
Duration Of Surgery

Background: Laparoscopic inguinal hernia repair has been proven to be a safe and effective procedure for groin hernias. In recent years, many of the tertiary centers in Nepal have started performing laparoscopic hernia repair. With the availability of resources and the facilities, the laparoscopic repairs for inguinal hernias are going to be more accessible in near future in Nepal. The aim of this study was to compare the intraoperative events and postoperative complications of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques of laparoscopic inguinal hernia repairs.Methods: Out of 56 patients, 30 underwent TAPP and 26 TEP repairs for primary unilateral inguinal hernias and were prospectively analyzed. Patient demographics, past medical and surgical history, intraoperative, and postoperative events were recorded. Patients were followed-up for two years.Results: Demographic parameters were comparable in both the groups. The difference in mean operating time was statistically significant (longer in the TAPP group). Intraoperative events such as port-site bleeding and peritoneal tear were comparable in both groups. The immediate postoperative complications like skin ecchymosis, cord hematoma, and scrotal edema were comparable in both repairs.  Immediate postoperative pain was significantly lesser in TEP repair whereas the hospital stays and time to return to the normal physical activity were comparable in both groups.Conclusions: Both TAPP and TEP laparoscopic techniques are safe and effective for inguinal hernia repair. However, there are few advantages of TEP repair such as shorter duration of surgery and less postoperative pain.

scholarly journals Sac ligation in inguinal hernia repair: A meta-analysis of randomized controlled trials

2015 ◽  
Vol 19 ◽  
pp. 55-60 ◽  
Author(s):  
Chun-Yu Kao ◽  
Ching-Li Li ◽  
Chao-Chun Lin ◽  
Chih-Ming Su ◽  
Chia-Che Chen ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Randomized Controlled Trials ◽  
Inguinal Hernia Repair ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

scholarly journals Inguinal hernia repair – TEP or TAPP?? A comparative analysis between both the laparoscopic procedures in a tertiary care center

2020 ◽  
Vol 11 (6) ◽  
pp. 84-88
Author(s):  
Atia Zaka Ur Rab ◽  
Sheikh Saif Alim ◽  
Wasif Mohammad Ali ◽  
Syed Amjad Ali Rizvi
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Prospective Study ◽  
Hospital Stay ◽  
Inguinal Hernia Repair ◽  
Tertiary Care ◽  
Number Of Patients ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Normal Work

Background: Inguinal hernia surgery is one of the most common elective procedures performed by the surgeons and has evolved from open to the laparoscopic technique. Aims and Objectives: This prospective study was conducted to find out intra-operative and post-operative outcomes in patients undergoing TEP and TAPP for inguinal hernia repair. Materials and Methods: A prospective study was conducted on 50 adult patients who underwent laparoscopic inguinal hernia repair between November 2017 to November 2018. It was a randomized study and equal number of patients were allocated to TAPP and TEP group based on the surgeon’s preference. Results: Operative time [p<0.0001], intensity of pain (VAS) was significantly higher in TAPP compared to TEP in the immediate post-operative period (6 hours) and during hospital stay [p=0.0299]. No significant difference observed in VAS between TEP and TAPP during follow up [after 1 week (p=0.2298), 2 weeks (p=0.2337), and 4 weeks (p=0.3944)]. Both TEP and TAPP were comparable in terms of Intra-operative and Post-operative complications {seroma [during hospital stay (p=0.1573), after 1 week (p=0.6375), after 2 weeks (p=0.5513)]; haematoma [during hospital stay (p=0.1492), after 1 week (p=0.3125)]} and Conversion (p=0.3125), and Length of hospital stay (p=0.3960). Time to resume normal work [p<0.0001] was significantly more in TAPP than TEP. Conclusion: TEP has a definite edge over TAPP taking into consideration the lesser intensity of post-operative pain during hospital stay, shorter duration of surgery and relatively early return to normal work associated with the former procedure. TEP should therefore be regarded as the procedure of choice for inguinal hernia repair.

Sign in / Sign up

Export Citation Format

Share Document