ArticleHernia : the journal of hernias and abdominal wall surgery2023
Improved patient-reported outcomes after open preperitoneal inguinal hernia repair compared to anterior Lichtenstein repair: 10-year ACHQC analysis.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Incidence and predictors of chronic pain after inguinal hernia surgery: a systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2024Pooled it
- Tailor-made approach for ambulatory open groin hernia repair: our experience of over 7000 cases.Surgery today · 2026Article
- Do patient-reported outcomes reliably screen for radiographic hernia recurrence? External validation of the ventral hernia recurrence inventory.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Ambulatory bilateral groin hernia repair: open preperitoneal versus laparoscopic outcomes.Hernia : the journal of hernias and abdominal wall surgery · 2025Article
- Groin Hernia Repair, the History of the Open Pre-Peritoneal Route Towards a Minimally Invasive Approach. Narrative Review.Journal of abdominal wall surgery : JAWS · 2025Review
- Comparison and Standardisation of Various Open Preperitoneal Techniques in Inguinal Hernia Surgery-Results of a Review and Consensus.Journal of abdominal wall surgery : JAWS · 2025Review
- Learning and implementation of TransREctus sheath PrePeritoneal procedure for inguinal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Open vs. robot-assisted preperitoneal inguinal hernia repair. Are they truly clinically different?Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Acceptance of Open Preperitoneal Repair in Inguinal Hernia Surgery Delphi-Consensus After an Anonymous International Survey Among European Hernia Society Members.Journal of abdominal wall surgery : JAWS · 2024Article
- A Call to Change the Nomenclature of "Open" Inguinal Hernia Repair.Journal of abdominal wall surgery : JAWS · 2024Article
- Delivering what inguinal hernia patients really really want.Hernia : the journal of hernias and abdominal wall surgery · 2023Article
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Authors and funding
8 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe Lichtenstein repair has been synonymous with "open" inguinal hernia repair (IHR) for 40 years. However, international guidelines have suggested that posterior mesh placement results in advantageous biomechanics and reduced risk of nerve-related chronic pain. Additionally, the use of local anesthetics has been shown to reduce postoperative pain and complication risks. An open transrectus preperitoneal/open preperitoneal (TREPP/OPP) repair combines posterior mesh placement with the use of local anesthetic and as such could be the ideal repair for primary inguinal hernia. Using the Abdominal Core Health Quality Collaborative (ACHQC) registry, we compared open anterior mesh with open posterior mesh repairs.
methodsWe performed a propensity score matched analysis of patients undergoing open IHR between 2012 and 2022 in the ACHQC. After 1:1 optimal matching, both the TREPP/OPP and Lichtenstein cohorts were balanced with 451 participants in each group. Outcomes included patient-reported quality of life (QoL), hernia recurrence, and postoperative opioid use.
resultsImprovement was seen after TREPP/OPP in EuraHS QoL score at 30 days (OR 0.558 [0.408, 0.761]; p = 0.001), and the difference persisted at 1 year (OR 0.588 [0.346, 0.994]; p = 0.047). Patient-reported opioid use at 30-day follow-up was significantly lower in the TREPP/OPP cohort (OR 0.31 [0.20, 0.48]; p < 0.001). 30-day frequency of surgical-site occurrences was significantly higher in the Lichtenstein repair cohort (OR 0.22 [0.06-0.61]; p = 0.007). There were no statistically significant differences in hernia recurrence risk at 1 year, or rates of postoperative bleeding, peripheral nerve injury, DVTs, or UTIs.
conclusionOur analysis demonstrates a benefit of posterior mesh placement (TREPP/OPP) over anterior mesh placement (Lichtenstein) in open inguinal hernia repair in patient-reported QoL and reduced opioid use.
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