| Objective: By comparing laparoscopic totally extraperitoneal inguinal hernia repair(TEP)and the open tension-free inguinal hernia repair(Millikan)impact on the quality of the patient’s life,providing a reference for inguinal hernia patients choose a better Inguinal hernia repair.Methods: From January 2015 to November 2015,60 cases of patients with primary unilateral inguinal hernia were treated in Gastrointestinal Surgery,Second Hospital of Hebei Medical University,excluding the patients who have severe disease affecting the quality of patient’s life.Including 56 males and 4 females,From 30 to 65 years old,the diameter of Inguinal hernia ring defect 2.0 ± 0.9cm,patients were randomly divided into laparoscopic group and open group,Half of them were treated by laparoscopic totally extraperitoneal inguinal hernia repair with the method of general anesthesia,the patch material used for the United States(Ke Hui)Polyester anatomic patch;The rest of the people were treated by millikan hernia repair operation with Herniamesh patch(plug and patch)was performed under Continuous epidural anesthesia.OUTCOME MEASURES are recorded: The mean operation time,first ambulation time,Persistent postoperative pain time(without Painkillers),free ambulation time,Application number painkillers after surgery;and after one month and six month,SF-36 quality of life questionnaire filled out by the patient,Followed-up by telephone and text recording format to observe physiological function(PF),role physical(RP),bodily pain(BP),general health(GH),energy(VT),social function(SF),emotional function(RE)and mental health(MH),The results of these data analyzed by the SPSS 13.0 statistical software,P <0.05 was considered statistically significant.Results: Surgery went smoothly,no intraoperative complications,none of the patients were lost to follow,After the results of data collected,the results are as follows,Through the analysis of OUTCOME MEASURES,found that in addition to the application of pain medication,the rest of them P<0.05,the differences were statistically significant.Compared TEP group with millikan group,the mean operative time,in the first ambulation time,Persistent postoperative pain time(without Painkillers),free ambulation time,TEP group were shorter than millikan group;in TEP group,there were two people with painkillers,in millikan group,There were five people use painkillers,one of whom used twice,P> 0.05,the difference about the application of painkillers was not statistically significant,it is said that two groups has no significant difference in the postoperative analgesics;2 The postoperative follow-up data of TEP group and Millikan group in the statistical analysis of the SF-36 scale after one month,the physiological function(PF),role physical(RP),bodily pain(BP),social function(SF),emotional function(RE)P <0.05,the difference has statistically significant,that is,The postoperative quality of life in postoperative physiological function(PF),role physical(RP),bodily pain(BP),social function(SF),role emotional comparison(RE),TEP group were better than Millikan group,but the comparisons in general health(GH),energy(VT),mental health(MH),P> 0.05,the difference was not statistically significant,That is the comparison of these three areas,TEP group does not make much difference with Millikan group;3 The postoperative follow-up data of TEP group and Millikan group in the statistical analysis of the SF-36 scale after six month,the physiological function(PF),social function(SF),role emotional(RE),P < 0.05,the difference has statistically significant,that is,The postoperative quality of life in postoperative physiological function(PF),social function(SF),role emotional comparison(RE),TEP group were better than Millikan group,while in other aspects P> 0.05,the difference was not statistically significant,It is said that there is not much difference between TEP group and Millikan group.Conclusion: Both laparoscopic totally extraperitoneal inguinal hernia repair(TEP)and open tension-free inguinal hernia repair(Millikan)have the advantages of the low rate of recurrence and less trauma,on the surgeon’s skill level requirements of open tension-free inguinal hernia repair(Millikan)lower than laparoscopic hernia repair,grass-roots hospitals can carry out.Focus on the quality of patient’s life after surgery,postoperative recovery of physical function,laparoscopic hernia repair is far superior to the open hernia repair,laparoscopic inguinal hernia repair will become the trend of inguinal hernia repair in future,However,clinical doctor’s surgery technology,which also become the surgical clinicians will face and solve problems。... |
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