LICHTENSTEIN, TAPP, AND TEP: COMPARATIVE ASSESSMENT OF POSTOPERATIVE PAIN INTENSITY

Abstract

Summary. One of the indicators of choosing a method of inguinal hernia repair is the intensity of the pain syndrome. Intense postoperative pain causes discomfort in the patient, prolongs the period of physical rehabilitation and the patient’s stay in the hospital. The aim of the study. To evaluate the intensity of postoperative pain syndrome in patients who used different methods of inguinal hernia repair: Lichtenstein, TAPP and TEP. Research materials and methods. We performed inguinal hernia repair in 211 patients. Lichtenstein repair was performed in 65 of them (Lichtenstein group), TAPP in 81 patients (TAPP group), and TEP in 65 (TEP group). Hernia repair was carried out according to generally accepted techniques described in the literature. The patients of all groups had a standard analgesia scheme. The pain syndrome was assessed using the Visual Analogue psychometric scale. Research results and their discussion. In the Lichtenstein group, the pain index on the first postoperative day was 5.09±1.66. On the third day, it decreased significantly (p<0.05) (r=0.28) and was 1.76±1.01. In the TAPP group, on the first postoperative day, patients rated their pain syndrome as 5.17±1.67. From the third postoperative day, the pain index decreased significantly (p<0.001) (r=0.42) and was 1.80±0.85. In the TEP group, there was a decrease in the pain syndrome index from 5.67±1.58 on the first postoperative day to 2.38±0.84 (3 days), but it was not reliable and had a weak correlation. Conclusions. On the first postoperative day, the most uncomfortable procedure was the TEP technique. The VAS score in this group was improbably the highest compared to the Lichtenstein and TAPP groups. On the third postoperative day, there was a probable decrease in pain syndrome in the Lichtenstein and TAPP groups, and an improbable decrease in the TEP group.