Hedberg HM, et al. – This research correlates general and disease–specific quality of life following totally extraperitoneal (TEP) laparoscopic inguinal hernia repair (LIHR) of asymptomatic and symptomatic hernias. Researchers exhibited evidence that asymptomatic individuals undergoing TEP LIHR reported less postoperative pain, returned to baseline activities, and discontinued pain medication sooner than symptomatic patients. These outcomes are encouraging and may inform patient–centered discussions about asymptomatic hernia repair.

Methods

• Between 2009 and 2015, researchers examined prospective data from 387 patients who underwent TEP LIHR by four surgeons at a single institution.
• They distinguished asymptomatic individuals by pain scores of zero at preoperative clinic visits.
• In this study, validated quality of life (QOL) measurements were administered preoperatively and at 3 weeks, 6 months, and 1–year postop.
• Moreover, comparisons were made applying Chi–square test, t test, or Mann–Whitney U test.
• Alterations over time were evaluated applying longitudinal mixed effects models.

Results

• They compared a cohort of 79 asymptomatic cases with 308 symptomatic individuals.
• The data confirmed that asymptomatic cohort had larger median hernia defects (2.5 vs 2 cm, p < 0.01), was older (mean 63.0 vs 58.9 years, p = 0.03), included fewer indirect hernias (57.7 vs 74.9%, p < 0.01), took pain medication for fewer days (mean 1.2 ± 1.5 vs 2.2 ± 3.0 days, p = 0.02), returned to baseline activities of daily living earlier (median 3 vs 5 days, p < 0.01), and reported decreased postoperative pain (p = 0.02).
• No significant difference was observed in general QOL.
• In the asymptomatic group, there was one recurrence and were two in the symptomatic cohort.