Could long-term follow-up modify the outcomes after laparoscopic TAPP? A 5-year retrospective cohort study

PurposeLaparoscopic inguinal hernia repair (LIHR) has demonstrated multiple benefits. However, long-term results regarding recurrence and quality of life (QoL) are still on debate. We aimed to analyze postoperative outcomes with long-term follow-up after LIHR.MethodsA consecutive series from December 2012 to May 2017 of laparoscopic TAPP was included. A minimum of 6months of follow-up was required for inclusion. The sample was divided into two groups, G1: patients with recurrence and G2: patients without recurrence. Patient's characteristics, operative variables and postoperative outcomes were analyzed. A QoL survey (Eura-HS QoL) was performed in the pre- and postoperative period.ResultsA total of 717 laparoscopic TAPP were performed in 443 patients. On univariate analysis, smoking, previous recurrence, mesh size smaller than 12x15cm and surgical teams with less than 30 cases/year showed an increased recurrence rate (p<0.05). But only smoking and less experienced teams were statistically significant on multivariate analysis (p<0.01). After a 2-year follow-up, recurrence rate was 1.5%, while it increased to 2.6% (n=19) at 5-year follow-up. Sixty percent of patients answered QoL survey. Average preoperative scores of pain, activities restriction and aesthetic dissatisfaction improved significantly after 6months of follow-up in patients without recurrence.ConclusionsAfter LIHR, quality of life shows a significant improvement in all parameters. Extending follow-up beyond 2years after laparoscopic TAPP allows a more accurate assessment of recurrence rate. Smoking and inexperienced teams were significant risk factors for its development.