A Controlled Study Of Laparoscopic Inguinal Hernia Repair For Bilateral Inguinal Hernia In Adults

Objective: Through retrospective analysis of the clinical data of OTFH(open tensionfree herniorrhaphy)and LIHR(laparoscopic inguinal hernia repair)in the treatment of bilateral inguinal hernia,the clinical data of the two surgical methods were compared,and the advantages and disadvantages of the two surgical methods were analyzed,so as to provide reference and data support for clinicians to choose surgical methods for adult patients with bilateral inguinal hernia.Methods:Thirty adult patients with bilateral inguinal hernia treated by open tension-free herniorrhaphy in Peking University shenzhen Hospital from September 2015 to June2018 were selected as OTFH.Another 30 adult patients with bilateral inguinal hernia treated by laparoscopic inguinal hernia repair in the same period were selected as LIHR.The patients in laparoscopic inguinal hernia repair group were followed up by telephone.The operation time,intraoperative bleeding volume,total hospitalization expenses,postoperative hospitalization time,Numeric Rating Scale(NRS),short-term complications and long-term complications were compared between the two groups.Results: 1.Operation time: Statistical results of OTFH group and LIHR group:(62.8±7.95)min VS(79.5±24.65)min(P < 0.01).The operation time of OTFH group was shorter than that of LIHR group;2.Intraoperative bleeding volume: statistical results of OTFH group and LIHR group:(44.0±13.09)ml VS(52.5±12.2)ml,(P < 0.01).The amount of bleeding during operation in OTFH group was less than that in LIHR group;3.Total hospitalization expenses: the statistical results of OTFH group and TEP group:(17779.7±468.6)yuan VS(21932.7±616.4)yuan,OTFH group had less bleeding during operation than that in LIHR group;4.Postoperative hospitalization time: thestatistical results of OTFH group and LIHR group:(4.43±1.52)D VS(2.7±0.79)d,the hospitalization time in LIHR group was less than that in OTFH group on the first day after operation;5.Pain score: Statistical results of control group and observation group:(4.1± 1.18)point VS(3.13 ±1.01)point,pain score of LIHR group on the first day after operation was lower than OTFH group.6.Recent complications in OTFH group included 1 case of cyst swelling,1 case of incision redness and 2 cases of subcutaneous ecchymosis.Recent complications in LIHR group included 2 cases of scrotal swelling,1case of incision exudation and 1 case of urinary tract infection.7.The follow-up period was 8-30 months,with an average of 16.32 months.There were 2 cases of chronic pain,3 cases of foreign body sensation,1 case of stiffness,1 case of neurosensory abnormality,2 cases of traction sensation and 1 case of recurrence in OTFH group,3cases of chronic pain,2 cases of foreign body sensation,1 case of stiffness,1 case of neurosensory abnormality,1 case of traction sensation in LIHR group,and no recurrence.Conclusions: For adult patients with bilateral inguinal hernia,OTFH group had shorter operation time,less intraoperative bleeding and lower total hospitalization cost than LIHR group(P < 0.05).LIHR group had shorter time to recover normal life and lower NRS pain score on the first day after operation than open tension-free repair group(P <0.05).There was no significant difference in the short-term and long-term complications between LIHR group and OTFH group(P > 0.05).