腹腔镜完全腹膜外疝修补术、腹腔镜经腹膜前疝修补术与开放式无张力疝修补术治疗腹股沟疝的效果比较

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Abstract Objective To explore the effect of laparoscopic total extraperitoneal hernia repair (TEP), laparoscopic preperitoneal hernia repair (TAPP) and open tension-free hernia repair for inguinal hernia, to analyze the effect of different surgical methods on recurrence, C-reactive protein (CRP) and interleukin-6 (IL-6) levels in peripheral blood of patients. Methods A retrospective analysis was conducted on 159 cases of inguinal hernia patients admitted to the Second Department of General Surgery, Beijing Renhe Hospital from February 2019 to June 2020, and they were divided into three groups according to surgical methods. Fifty-three patients in the observation group 1 received TEP, 53 patients in the observation group 2 received TAPP, and 53 patients in the control group received open tension-free hernia repair. The amount of intraoperative blood loss, operation time, postoperative activity time out of bed and hospitalization time of the three groups were compared. Serum indexes and visual analogue scale (VAS) scores of three groups were compared. The total incidence and recurrence rate of complications were compared among the three groups. Results There were no significant differences in operation time, postoperative activity time and IL-6 between the observation group 1 and the observation group 2 (P＞0.05). The amount of intraoperative blood loss in observation group 1 was less than that in observation group 2, and the length of hospital stay was shorter than that in observation group 2, with statistical significances (P＜0.05). The amount of intraoperative blood loss in observation group 1 and observation group 2 was less than that in control group, and the duration of operation, postoperative activity time out of bed and hospital stay were shorter than those in control group, with statistical significances (P＜0.05). The CRP and VAS score at 48 h after operation in the observation group 1 were lower than those in the observation group 2, the differences were statistically significant (P＜0.05). IL-6 and CRP at 48 h after operation and VAS scores at 24 and 48 h after surgery in observation group 1 and observation group 2 were lower than those in control group, the differences were statistically significant (P＜0.05). The total incidence and recurrence rate of postoperative complications in observation group 1 were lower than those in control group, and the difference was statistically significant (P＜0.017). The total incidence and recurrence rate of postoperative complications in the observation group 2 were lower than those in the control group, but after adjustment, the differences were not statistically significant (P＞0.017). Conclusion In the treatment of inguinal hernia, the use of TEP and TAPP can reduce the recurrence rate and reduce the inflammation. Compared with TAPP,the safety of TEP is more significant.

Key words： Laparoscope Extraperitoneal hernia repair Tension-free hernia repair Inguinal hernia Recurrence Inflammatory cytokines

Received: 19 February 2021

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