Comparative Study On The Clinical Effects Of TAPP And Lichtenstein For Inguinal Hernia

Objective:Compare the clinical efficacy,postoperative complications,surgical recovery,patient self-care ability,and the impact on the reproductive system of male patients between laparoscopic hernia repair(TAPP)and Lichtenstein traditional tension-free hernia repair.Analyze the clinical value of the two surgical methods.Method:We analyzed the case data of 148 patients with inguinal hernia who underwent surgery in our hospital from December 2016 to August 2020.The patients were divided into two groups based on different surgical methods: laparoscopic hernia repair group(TAPP group)and Lichtenstein traditional tension free hernia repair group(Lichtenstein group),with 74 patients in each group.Statistical and comparative analysis was conducted on the intraoperative indicators,postoperative complications and recovery,postoperative self-care ability,impact on male patients’ reproductive system,chronic pain during postoperative follow-up,and hernia recurrence rate of patients.Result:(1)The surgical time in the TAPP group was significantly longer than that in the Lichtenstein group(P<0.05);The incision length generated during surgery in the Lichtenstein group was significantly longer than that in the TAPP group(P<0.05);The intraoperative bleeding volume in the Lichtenstein group was significantly higher than that in the TAPP group(P<0.05);The hospitalization expenses of patients in the TAPP group were significantly higher than those in the Lichtenstein group(P<0.05);The hospitalization time of TAPP group patients was significantly shorter than that of Lichtenstein group patients(P<0.05).(2)The incidence of complications in the Lichtenstein group was significantly higher than that in the TAPP group(P<0.05);The use of painkillers in the Lichtenstein group was higher(27 times)than in the TAPP group(6 times);Immediately after anesthesia resuscitation,there was no statistically significant difference in pain score(VAS score)between the two groups of patients(P>0.05);At 24 hours and 72 hours after surgery,the TAPP group scored significantly lower than the Lichtenstein group(P<0.05);On the 1st,2nd,and 3rd day after surgery,the postoperative ADL score of the TAPP group was significantly higher than that of the Lichtenstein group(P<0.05).(3)The exmination of testicular temperature,serum testosterone level,and testicular ultrasound indicators including testicular volume,arterial blood flow resistance index(RI),peak systolic blood flow velocity(Vs),and end diastolic blood flow velocity(Vd)of male patients in the two groups showed that there was no significant change in the above reproductive system indicators on the healthy side and the affected side of patients before and after treatment(P>0.05),and there was no significant difference between the two groups(P>0.05).(4)Comparing the follow-up dysfunction scores(ODI scores)of the two groups of patients,two months after discharge,the ODI scores of the TAPP group and Lichtenstein group were significantly lower than those of the Lichtenstein group.The difference between the two groups was statistically significant(P<0.05).(5)Within 2 years after surgery,only 1 patient in the Lichtenstein group exhibited chronic pain;Within 2 years after surgery,there were 2 cases of recurrence in the TAPP group and 4 cases in the Lichtenstein group.There was no statistically significant difference in the recurrence rate between the two groups(P>0.05).Conclusion:(1)Both TAPP surgery and Lichtenstein tension-free hernia repair have good therapeutic effects on inguinal hernia,and have no significant impact on the patient’s reproductive ability.The long-term prognosis is comparable.(2)TAPP surgery is superior to Lichtenstein tension-free hernia repair in terms of the incidence of complications and short-term prognosis.