Insulin Resistance During Laparoscopic or Open Mesh Repairs of Inguinal Hernia in Young Males

BACKGROUND: We aimed to compare the post-operative insulin resistance and early-term clinical outcomes of laparoscopic total extraperitoneal (TEP) repair and open mesh repair (Lichtenstein) in congenital-type inguinal hernias in young males.
MATERIAL AND METHODS: A randomized, prospective, and double-blind study was planned. Twenty-six male patients with either type I or type II inguinal hernia according to Zollinger classification were operated on using the Lichtenstein technique or total extraperitoneal (TEP) technique. Insulin sensitivity measurement was performed twice on patients by using the hyperinsulinemic-euglycemic glucose clamp technique, once on the day before the operation and once 30 minutes postoperatively. We evaluated complications, pain, and life quality at 1 week and 1 month after surgery. Pain level was determined by visual analogue pain scale and life quality was determined by short-form 36 life quality assessment scales.
RESULTS: There was no difference between the Lichtenstein group M values (mean 4.91±2.25) and TEP group M values (mean 4.89±1.74) in terms of preoperative M values. There was a significant difference between Lichtenstein group M values (mean 3.60±2.34) and TEP group M values (mean 2.05±1.39) in terms of postoperative M values. Complication rates and visual analogue pain scale values of both groups were similar. In the short-form 36 life quality assessment scale, TEP group patients had higher scores in terms of emotional role at 1 week after surgery compared to the Lichtenstein group, but at 1 month after surgery we observed that the difference had disappeared.
CONCLUSIONS: For small- and medium-sized indirect inguinal hernia repairs in young males, the Lichtenstein technique causes fewer injuries than the TEP technique in the short-term, but in the long-term both techniques have similar durations of improvement.

Keywords: Hernia, Abdominal, Insulin, Medical Subject Headings