Quality of life after laparoscopic totally extraperitoneal (TEP) inguinal hernia repair with fibrin glue versus tack mesh fixation

Résumé

Mechanical methods are hypothesized to have postoperative pain and more seroma formation than non-mechanical methods due to tissue trauma. Therefore, the current prospective cohort study aimed to assess postoperative pain and quality-of-life (QoL) after fibrin glue versus tack mesh fixation. From July 2022 to December 2023, 80 patients sought TEP at the Suez Canal University Hospitals outpatient clinic. Participants were divided into two groups based on mesh fixation: the Fibrin glue group (FG) and the Tack group (TG). The purpose of this study was to compare the rate of post-operative complications, post-operative pain, length of hospital stays, and wound complications. In the meantime, the two groups QoL were compared using the SF-36 scoring questionnaire and the Caroline Comfort score (CCS). The patients in TG had higher operative time (84.5 ± 5.5 min) compared to patients in FG (78.3 ± 6.4); without statistical significance (p = 0.21). The FG had a statistically significant shorter length of hospital stay compared to TG (p = 0.02) although the duration till initiation of weight bearing did not have statistical difference between both groups (p = 0.09). With a 30-day postoperative follow-up period, overall, there was no difference between both groups regarding the development of postoperative urine retention, seroma or wound infection (p = 0.09, 0.32, 0.3; respectively). Furthermore, after 6 months, FG had a higher overall QoL score using both CCS and SF-36 questionnaire (P = 0.001 and 0.02; respectively). Glue fixation may have a better quality of life and less postoperative pain; however further clinical trials are still needed.

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