| Objective: To observe and contrast the clinical curative effects ofseparation free balloon, free stapling, double-patch interlocking overlappingmodified totally extraperitoneal laparoscopic hernia repair (TEP) and the cliniceffects of open plug-mesh tension-free inguinal herniorrhaphy.Methods: a retrospective analysis of the clinical data in our hospital from2008May to2013May,873adult patients underwent inguinal hernia operation.Among873patients,529patients were performed separation free balloon, freestapling, double-patch interlocking overlapping modified totally extraperitoneallaparoscopic hernia repair (TEP) is set to laparoscopic group,529patientswere performed open plug-mesh tension-free inguinal herniorrhaphy is set toopen group; Baseline characteristics,recurrence, and intraoperative, short-term,and long-termpostoperative complications were recorded and compared. Therecord results conduct with t test or2test.Results: Laparoscopy group of patients with postoperative hospital stay,postoperative blood loss, the first day postoperative VAS pain score and postoperative ambulation time respectively (4.9±2.9) days,(16.8±32.4) ml,(2.1±0.78) cm and (1.5±0.79) days, are better than the open group (6.5±3.6)days,(31±45.6) ml,(3.9±1.4)cm and (2.9±1.8) days, the difference wasstatistically significant,(P <0.05). But the hospitalization expenses oflaparoscopic group (12780±4715)yuan higher than the open group(9262±5293)yuan, the difference was statistically significant (P <0.05).operative times of laparoscopy group (109±28.3) minutes to slightly longer thanthe open group (71.5±21.8) minutes, but the difference was no statisticallysignificant (P>0.05). Two groups of patients with a recent total incidence ofcomplications,laparoscopic group (13.4%) was slightly lower than the opengroup (14.5%), but the difference was no statistically significant (P>0.05).short-term postoperative complications in laparoscopic group incidence ofscrotal seroma or hematoma (9.7%) higher than open group (5.4%), thedifference was statistically significant (P <0.05). The rest of short-termpostoperative complications difference has no statistical significance (P>0.05).In the total incidence of long-term postoperative complications,laparoscopicgroup (5.4%) less than open group (17.1%), the difference was statisticallysignificant (P <0.05). Laparoscopic group postoperative recurrence(0.6%),local foreign body sensation (4.17%), chronic pain (0.6%) were lessthan the open group (2%),(11.8%),(2.9%), the difference was statisticallysignificant (P <0.05).Conclusion: separation free balloon, free stapling, double-patchinterlocking overlapping modified totally extraperitoneal laparoscopic herniarepair (TEP) is safe and reliabl,compare with open plug-mesh tension-freeinguinal herniorrhaphy, the former has the advantages like recovery fast, smalltrauma, the pain is light, low postoperative recurrence rate, less postoperative body paresthesia,less chronic pain and so on. It is worthy of clinical promotionand application. |
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