A Clinical Control Study Of Laparoscopic Totally Extraperitoneal Prosthetic Verse Tension-Free Herniorrhaphy For Inguinal Hernia

Objective To compare the clinical effect of laparoscopic totally extraperitoneal prosthetic (TEP) with open tention-free inguinal hernia repair and to evaluate the feasible and economical methods for adult inguinal hernia repair.Methods A non-randomized concurrent control study was performed including 62 TEP(laparoscopic group) and 65 open tention-free inguinal hernia repair(open group) during Jan.2008 and Jan.2010. We followed up the patients postoperatively and compared the correlative parameters.Results Compared with the open repair group, the laparoscopic group presented longer operating time [(72±14)min vs (45±11)min,P <0.01], higher cost in hospital [(8547±391)yuan vs (5635±342)yuan,P <0.01].But the laparoscopic group had shorter postoperative hospital stay[(5±1)d vs (8±1)d,P <0.01] ,shorter time of return to normal activity[(12±1)h vs (20±2)h,P <0.01],less postoperative analgesic requirement(2/62 vs 11/65,P <0.05),shorter time of postoperative pain[(2±1)d vs (4±2)d,P <0.01]。In the open group,1 case had incision haematoma, 2 cases had scrotal swelling, 2 cases had urinary retention and 2 cases had chronic pain. While in the laparoscopic group, 3 cases had scrotal swelling, 2 cases had urinary retention and 1 case had intestinal obstruction. The total cases of complications in the two groups were 7 and 6, respectively. No significant difference was detected in complication between the two groups. All cases were followed up for 4～24 months with a median 16 months. No case recurred in the two groups during that period. Conclusion TEP as one of the tention-free inguinal repair operations is feasible and safe for adult patients with inguinal hernia. It has clinical complementary with open tension-free hernia repair. We should select the correct choice of repair method according to the patient personal situation to gain the best clinical and cost-effective results.