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Annals of Surgery Journal Club
Interactive resource for surgery residents and surgeons to discuss and critically evaluate articles published in Annals of Surgery selected by a monthly guest expert who will review an article each month, offer questions and respond to reader's comments.
Monday, April 02, 2012
April Journal Club

Using data from a prospectively collected registry, Belyansky et. al., evaluated patient centered outcomes in 2086 patients who underwent inguinal hernia repair via one of three methods: TEP, TAPP or ML (modified Lichtenstein). They found that the use of >10 tacks, lack of prostate pathology, recurrent hernia repairs and bilateral hernia repairs were predictors of postoperative pain. They also found less pain at one month in patients who underwent TEP repair compared to those who underwent ML repair, although at 6 months and 1 year no differences were observed.

Overall rates of symptoms (as measured by the Carolinas Comfort Scale) at 1 year was 6-8% and recurrence rates were also low.


1.   How should you translate the data from this study into how you treat patients with inguinal hernia repair?


2.    What are the limitations of this study?


3.    How are the results of this study similar or different from prior studies regarding quality of life after inguinal hernia repair? 


Please feel free to comment on any or all of the questions above. We look forward to hearing from you, the Annals readers.


About the Author

Gregory D. Kennedy, MD, PhD
Gregory D. Kennedy, MD, PhD is an Associate Professor of Surgery and Vice Chair of Quality in the Department of Surgery at the University of Wisconsin School of Medicine and Public Health in Madison, WI. As a busy colon and rectal surgeon he is passionate about quality improvement and tirelessly works to ensure care of the highest quality is delivered to the patients served by the UW. He serves on many committees charged with reducing health care associated infections and is the surgeon champion of the American College of Surgeons National Surgical Quality Improvement Project for UW Health.

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