Quantitative assessment of the impacts of stoppa repair and total extraperitoneal repair on the lower extremity muscular functions in cases of unilateral inguinal hernia: a randomized controlled study

• Published in: Hernia : the journal of hernias and abdominal wall surgery Vol. 21; no. 3; pp. 377 - 382
• Main Authors: Akgül, N., Yaprak, M., Doğru, V., Balci, N., Arici, C., Mesci, A.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01-06-2017; Springer Nature B.V
• Subjects: Abdominal Surgery; Adolescent; Adult; Aged; Decision making; Exercise; Female; Hernia; Hernia, Inguinal - surgery; Hernias; Herniorrhaphy; Humans; Isometric; Laparoscopy; Lower Extremity - physiopathology; Male; Medicine; Medicine & Public Health; Middle Aged; Muscle Strength; Muscle, Skeletal - physiopathology; Muscles; Original Article; Pain; Pain, Postoperative - physiopathology; Physical activity; Postoperative Period; Prospective Studies; Recovery of Function; Statistical analysis; Young Adult; Stoppa; Laparoscopy; Cybex device; Physical activity; TEP; Unilateral inguinal hernia
• ISSN: 1265-4906; 1248-9204
• DOI: 10.1007/s10029-016-1559-6

Purpose
Choosing the best operative technique for unilateral inguinal hernia is a challenge for surgeons. Therefore, anticipating loss of strength in the lower extremity muscles could be the initial step to make the right decision. To this end, this prospective randomized controlled study compared the physical activity parameters of the lower extremity muscles in patients who underwent total extraperitoneal repair (TEP) and Stoppa repair.
Methods
Fifty patients with unilateral inguinal hernia who were 18–65 years of age were admitted to a single institution in a metropolitan city in Turkey. Patients were randomized in a 1:1 ratio to parallel study arms of TEP and STOPPA repair. They were evaluated in the preoperative period and on the postoperative day 3 for an objective isometric and isokinetic assessment of the pain-related functional changes in the lower extremity muscles.
Results
The measurement results obtained with the Cybex device on the postoperative day 3 were presented as numeric parameters in the digital setting, where the Stoppa repair resulted in a higher loss of strength in the lower extremities compared to the TEP repair. With respect to the total workforce loss in isokinetic muscular measurements at 90 °C/s extension, 90 °C/s flexion, 180 °C/s extension and 180 °C/s flexion, the difference between the TEP repair and Stoppa repair was statistically significant in favor of TEP repair (
p
 < 0.05).
Conclusion
This study is the first comparative study in the literature to demonstrate the favorable impact of the laparoscopic hernia repair on the physical activity on the same anatomic site compared to the open surgical procedure by using quantitative values.
Trial registration
: Clinicaltrials.gov ID: NCT02813057.