Comparison Of The Transabdominal Preperitoneal (TAPP) And Totally Extraperitoneal (TEP) For Inguinal Hernia Repair: A Meta-analysis

Objective:To perform a meta-analysis of randomized controlled trials(RCTs)comparing tr ansabdominal preperitoneal(TAPP)with totally extraperitoneal(TEP)in regards of,operation time,hernia recurrence,pain scores,length of hospital stay,time to return to work,total complications and recurrence rate.Methods:Five databases(PubMed?Embase?Cochrane library?CNKI and WAN-FANG database)were comprehensively searched(publication dates ranging from library to 2018)with controlled clinical trials(RCTs)that compared TAPP and TEP for inguinal hernia repair.strictly screening accordance to the standard,assessing the quality of these studies,data were extracted from these trials and analyzed by the Review Manager 5.3 software.Results:There is a total of 9 RCTs which enrolling 1083 patients,of these,565 were in the TAPP group and 518 were in the TEP group.There was no significant difference in operative time,postoperative recurrence rate,hospital stay,postoperative recovery time,and total complications.The pain score of TEP was slightly lower than that of TAPP between 6 hours and 1 week after surgery.Conclusious:Both TAPP and TEP are reliable surgical methods.However,taking into account the longer learning cycle of TEP,we should use TAPP as the preferred surgical method for laparoscopic inguinal hernia repair,especially for nonexpert surgeons.The choice of surgical methods in reality is not specific,and can be flexibly selected according to the proficiency of the surgeon and the specific conditions of the patient.