Patient's satisfaction at 2 years after groin hernia repair: any difference according to the technique?

Long-term patient's satisfaction after groin hernia repair is rarely studied in the literature. The aim of this study was to compare the four main techniques of inguinal hernia repair in terms of patient's satisfaction and quality of life at the 2-year follow-up in a prospective registry.

From September 2011 to March 2014, consecutive patients underwent groin hernia repair and were prospectively included in the Club Hernie registry, which also consisted of expert surgeons in parietal repair. The data on patient demographics, clinical presentation, initial workup, operative technique, postoperative course, clinical follow-up, and quality of life at 2 years (2Y-FU) were recorded.

Overall, 5670 patients were included in the study: 1092 undergoing Lichtenstein's technique, 1259 for trans-inguinal preperitoneal technique (TIPP), 1414 for totally extraperitoneal approach (TEP) and 1905 for transabdominal preperitoneal approach (TAPP). The patients undergoing Lichtenstein's technique were significantly older, with more inguinoscrotal hernias and co-morbidities than those undergoing other techniques. A total of 83% patients had a complete 2Y-FU. The patient's satisfaction at 2Y-FU was similar between the different techniques. In the univariate and multivariate analyses, pain on postoperative day 1 was the only independent prognostic factor of the patient's satisfaction at 2Y-FU.

In this large series, no statistical differences were found between the four studied techniques regarding the 2Y-Fu results and patients' satisfaction. Provided the technique has been done properly (expert surgeon) the results and the patients' satisfaction are fair and equivalent among the four studied techniques. In a multivariate analysis, the only factor predictive of bad late results was severe pain at D1.