Chronic groin pain following inguinal hernia repair in the laparoscopic era: Systematic review and meta-analysis.

Abstract

<h4>Background</h4>The impact of laparoscopic inguinal hernia repair (IHR) on chronic groin pain (CGP) prevalence, risk and daily activities compared to open IHR is still unclear.<h4>Methods</h4>A meta-analysis of randomised controlled trials comparing CGP rates in laparoscopic and open IHR was performed.<h4>Results</h4>22 trials were included. CGP prevalence decreases significantly 1-2 years post-op and reaches rates as low as 4.69% (laparoscopic) and 6.91% (open) at >5 years. There is a significantly lower risk of CGP following totally extraperitoneal (TEP) than open mesh repair at all follow-up periods (p < 0.05) except for >5 years (p = 0.32). The same trend is not seen when compared to open non-mesh repair or for transabdominal pre-peritoneal repair (TAPP). There is no difference between techniques when CGP is described as moderate and/or affecting daily activities (p = 0.08).<h4>Conclusion</h4>CGP rates continue to decrease at >5 years follow up. TEP consistently results in a reduction in CGP rates compared to open mesh repair however, this is not functionally significant.