BACKGROUND: A variety of procedures with substantial differences in results are employed to treat recurrent @entity169 . The advantages of totally extraperitoneal patch repair (TEP) are even more evident when it is applied to recurrent compared to primary @entity547 . To investigate the superiority of this method more closely, we reviewed our results obtained for recurrent @entity169 over a period of 2 years. METHODS: We performed a prospective single-center study using data obtained in consecutive @entity1 with recurrent @entity169 who were operated on in 1997 and 1998. RESULTS: A total of 179 @entity1 with recurrent @entity169 were recruited. Overall, 1329 @entity1 with @entity169 were treated in the 2-year period, of whom 1270 underwent TEP. The percentage of recurrent @entity547 was 14%. The average age of the @entity1 was 56 years. The follow-up rate was 87.5%, and the mean follow-up period was 2.3 years. The 154 @entity1 who were followed up underwent a total of 225 @entity547 repairs, of which 181 were for recurrent @entity547 . The average operating time was 57 min. In 68% (104/154) of the @entity1 , adhesions, adherent epigastric vessels, or cicatricial changes were found, which resulted in the inadvertant opening of the peritoneum in 26.3% of the @entity1 . All the openings in the peritoneum were closed by endoscopic suturing. Intraoperative complications developed in 4 @entity1 (2.3%), including one @entity1494 and three cases of @entity548 from side branches of the epigastric vessels. The conversion rate was 0%. The sole postoperative complication was treatment requiring @entity1410 in 7 @entity1 , in 2 of whom reoperation became necessary. In both cases, a @entity548 due to a preoperatively undiagnosed @entity3459 was found. No cases of wound or patch infection were observed. In a @entity1 undergoing both primary and recurrent @entity547 repair, displacement of a mesh led to a recurrence on the primary @entity547 side (recurrence rate, 0.4%; re-recurrence rate, 0%). CONCLUSIONS: Although for its definitive management, recurrent @entity547 requires a reliable operative technique, current data do not support the recommendation of any of the currently available procedures as the gold standard. In a representative @entity1 population with recurrent @entity547 , we were able to demonstrate that TEP achieves very good results in terms of re-recurrence rate, @entity260 , and rehabilitation. Prerequisites for the reliable and low-complication application of the method are a high level of standardization of the procedure and an advanced learning curve.

Totally extraperitoneal repair of recurrent XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity548 :: ('MESH:D006470', 'Disease') :: ['diffuse hemorrhage', 'bleeding'] @entity1494 :: ('MESH:D001745', 'Disease') :: ['injury to the bladder'] @entity260 :: ('MESH:D011183', 'Disease') :: ['intraoperative and postoperative complications'] @entity3459 :: ('MESH:D025861', 'Disease') :: ['coagulation disorder'] @entity1410 :: ('MESH:D006406', 'Disease') :: ['hematomas'] @entity547 :: ('MESH:D006547', 'Disease') :: ['hernia', 'hernias'] @entity169 :: ('MESH:D006552', 'Disease') :: ['inguinal hernias', 'inguinal hernia']
@entity169 :: (MESH:D006552,Disease) :: ['inguinal hernia']
