Perioperative medicine & outcomes
Comparison of Postoperative Outcomes of Laparoscopic vs Open Inguinal Hernia Repair
Authors' conclusion
In this study, laparoscopic and open repair with local anesthesia were reasonable options for patients with initial unilateral inguinal hernias, and the decision should be made considering both patient and surgeon factors.
Study context
- Population
- Patients undergoing unilateral initial inguinal hernia repair, Veterans Affairs Surgical Quality Improvement Program database, 1998–201999.5% men
- Participants
- 107,073 patients
- Exposure
- Laparoscopic repair vs open repair under GA or local anesthesia
- Open localn = 22,333
- Open generaln = 75,104
- Laparoscopicn = 9,636
- Outcome
- Operative time and postoperative morbidity
Methodological detailsinverse probability propensity weighting, quantile regression, 2-stage least-squares regression, probabilistic sensitivity analysis
- Inverse probability propensity weighting
- Quantile regression
- 2-stage least-squares regression
- Probabilistic sensitivity analysis
Main finding
As reported in the abstract
Postoperative complications and operative time
Difference in postoperative complications (95% CI)P value
Laparoscopic vs Open generalnonsignificant reduction
−0.15%(−0.39 to 0.09)
P = 0.22Laparoscopic vs Open local
−0.05%(−0.34 to 0.28)
P = 0.70Difference in operative time, minutes (95% CI)P value
Laparoscopic vs Open generaldescribed as similar
4.31(0.45–8.57)
P = 0.048Laparoscopic vs Open local
10.42(5.80–15.05)
P < 0.001Observational data: associations, not effects.
Original publication
Comparison of Postoperative Outcomes of Laparoscopic vs Open Inguinal Hernia Repair. JAMA Surg. Published 1 February 2023. doi:10.
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