Purpose
To compare open Lichtenstein repair and laparoscopic transabdominal
preperitoneal (TAPP) repair to treat primary unilateral hernia, regarding
systemic inflammatory response, postoperative pain, and complications.
Methods
A non-randomized prospective cohort study, with the preoperative and
postoperative (24 hours) collection of blood samples for C reactive protein
(CRP), interleukin 6 (IL-6), leukocyte and neutrophil analysis. Visual
Analog Scale (VAS) was used to quantify the level of pain, and the operative
time was correlated with the inflammatory response. VAS and CRP were also
obtained on the 8th postoperative day.
Results
Groups were homogeneous regarding preoperative characteristics. There were no
differences between groups in 24h values of CRP, IL-6, leukocytes,
neutrophils or VAS. Similarly, CRP and VAS did not differ between groups on
the 8th postoperative day. However, the operative time for laparoscopic
hernia repair was longer than the time for the open procedure. There was a
weak correlation (r coefficient 0.31) between the duration of the surgical
procedure and the VAS score at the eighth day.
Conclusions
There were no statistically significant differences in the inflammatory
response, pain scores, or complications between groups. We conclude that
there is no advantage performing a primary unilateral hernia repair by
laparoscopy.