BACKGROUND: The Shouldice technique is the 'gold standard' of open non-mesh hernia repair. The aim of this study was to compare 5-year recurrence rates after Shouldice and laparoscopic transabdominal preperitoneal patch (TAPP) repair for primary @entity169 . METHOD: @entity1 with a primary @entity169 were randomized to either Shouldice or TAPP operation. An independent observer scored the surgeons' performance. Follow-up comprised clinical examination after 1 year, a questionnaire after 2 and 3 years, and a clinical examination after 5 years. RESULTS: Between February 1993 and March 1996, 1183 @entity1 were included. Nine hundred and twenty @entity1 were followed for 5 years, 454 in the TAPP group and 466 in the Shouldice group. Recurrences were evenly distributed between groups throughout the follow-up period. The cumulative recurrence rate after 5 years was 6.6 per cent in the TAPP group and 6.7 per cent in the Shouldice group. @entity282 was a risk factor for recurrence after Shouldice operation but not after TAPP repair. There was a correlation between a low surgeon's performance score and recurrence. CONCLUSION: The 5-year recurrence rate is acceptable, with no difference between TAPP and Shouldice repair. Poor operative performance resulted in a higher recurrence rate. The TAPP operation represents an excellent alternative for primary @entity169 .

Randomized clinical trial comparing 5-year recurrence rate after laparoscopic versus Shouldice repair of primary XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'Men'] @entity169 :: ('MESH:D006552', 'Disease') :: ['unilateral inguinal hernia', 'inguinal hernia repair', 'inguinal hernia'] @entity282 :: ('MESH:D010149', 'Disease') :: ['Postoperative pain']
@entity169 :: (MESH:D006552,Disease) :: ['inguinal hernia']
