Clinical Study Of Adult Laparoscopic Inguinal Hernia Repair And Open Inguinal Hernia Repair

Objective: through adult laparoscopic inguinal hernia repair(LIHR) prospective randomized clinical study and open inguinal herniarepair, to further clarify the safety and superiority of laparoscopictreatment of inguinal hernia. Methods: the Department of general surgeryof Yibin First People’s Hospital in2012January to100cases of adultpatients with inguinal hernia treated in our hospital from2013Januaryaccording to the order of admission number, were randomly divided intoodd and even number group array, the array of50patients assigned to theodd even number group of50cases of laparoscopic group, scheduled toopen group. Laparoscopic group were treated with general anesthesia, theodd group of25cases underwent total peritoneal extranet herniorrhaphy(TEP) and the odd group25cases underwent transabdominalpreperitoneal repair (TAPP); the open group of50patients underwentdouble tension-free hernioplasty.100patients were followed up for1years (for the outpatient visits, telephone follow-up or medical personnelhome follow-up methods combined), and complications were recordedafter recovery, build statistical data. The following parameters wereobserved and compared two groups of patients: including operation time,cost of hospitalization, postoperative complications, recurrence,postoperative analgesic drug use cases, incisional pain duration, postoperative bed time, postoperative participate in normal activities,patients with incision satisfaction for statistical analysis. Results: the twogroups of patients with inguinal hernia in gender, age, type of hernia,location, concomitant diseases clinical data of no significant difference(P>0.05), was comparable between the two groups of data. The opengroup of50patients, all accept the double tension-free hernioplasty. Atotal of50cases of laparoscopic group,25cases were treated with TAPP,1cases were converted to open tension-free hernia repair; diseaseunderwent TEP treatment in25cases, of which only2were convertedinto TAPP treatment. Operation time of laparoscopic group was59.11±14.15(points), the hospitalization expenses of12540.3±2582.3(yuan),the hospitalization time was3.57±1.52(day); open operation time was40.21±11.11(points), hospitalization expenses of6709.6±1477.8(yuan), the hospitalization time was6.39±3.63(days). Laparoscopicoperation time long, the hospital cost was high, compared with the opengroup had statistically significant differences (P=0.000,0.000). Thelaparoscopy group had shorter hospitalization time, compare thedifferences and the open group (P=0.047). Complications after operationin the two groups (local hematoma, repair area pain, scrotal swelling,urinary retention, patch infection) had no significant difference (X2=0.65,P=0.275); no recurrence after laparoscopic group and open group,recurrence in1patients, two groups in the postoperative recurrence was no significant difference (P=0.484). Laparoscopic hernia repair in3cases after the use of analgesics, and open hernia repair in4cases; two cases of ambulation after operation (P=0.001) and incision pain duration (P=0.001) there were significant differences; two cases in normal activities after operation (P=0.230) and incision satisfaction (P=0.242) there was no significant difference in statistics. Conclusion:laparoscopic hernia repair operation time is open herniorrhaphy length, total cost of hospitalization was higher than that of the open group, but intraoperative, postoperative complications and long-term complications and recurrence rate were no significant difference in the probability of occurrence, and laparoscopic hernia repair patients has the advantages of fast, start work early, operation time incision pain of short duration, the use of analgesics, postoperative recovery and less postoperative; moreover, laparoscopic inguinal hernia repair is more in line with the normal anatomical and physiological structure of the human body, so the adult inguinal hernia underwent laparoscopic hernia repair surgery is safe, feasible, and in postoperative recovery of laparoscopic inguinal hernia repair art has its unique advantages compared with open repair of hernia.