A Comparative Study Of Three Different Opration Way In Treatment Of Inguinal Hernia

Objective: By compare laparoscopic totally extraperitoneal inguinal hernia repair(Totally Extraperitoneal Prosthetic, TEP) and laparoscopic transabdominal preperitoneal(,TAPP) with local nerveblockade anaesthesia for tension-free herniorrhaphy(local anesthesia open group) treatment for adult inguinal hernia, in order to explore reasonable and economy inguinal hernia repair. Methods: Date Collected fifty cases TEP(TEP group) and forty-eight cases TAPP(TAPP 组) and forty-two cases under local nerveblockade anaesthesia for tension-free herniorrhaphy(local anesthesia group) from the First Affiliated Hospital of Xinjiang Medical University in January 2012 to December2014,to carried out the same period non-randomized concurrent control study.We follow-up patients of three groups to compared patients’ preoperative and postoperative parameters Postoperative.Results: 1.Measuring index:①Operating time:Compared the TEP group、TAPP group and local anesthesia group,the presented langer operative time[(64.5±15.4)min VS(97.8±15.3)min VS(43.3±16.55)]min,comparison between any two group,the sequence from longer to shorter is TAPP group>TEP group> local anesthesia group(P < 0.05).② postoperative intestinal motility regain time :Local anesthesia group peristalsis recovery time is much shorter than laparoscopic in the two groups[(14.4±8.3)h VS(16.5±7.5)h VS(8.6±3.8)h](P<0.05). ③postoperative hospital stay time :Local anesthesia group of patients in hospital was shorter than the other two groups [( 4.4 ± 1.0)d VS(4.3 ± 1.0)d VS(3.2 ± 1.0)d,P <0.05)]; ④ the cost of hospitalization:The two groups of laparoscopic were higher than local anesthesia open group [(12054.6±412.4)RMB VS(11675.8±327.3)RMB VS(5423.9±378.8) RMB, P<0.05)]. ⑤The postoperative pain VAS scores: Postoperative pain score anesthesia group was obviously higher than that of other two groups[( 0.7±0.4)point VS(0.8±0.7) point VS(2.5± 0.6)point,P <0.05]. 2 Count indicators:The postoperative complications :TEPgroup presented 1cases in the scrotum effusion, TAPP group scrotum hematoma 1 case,appear chronic pain in the groin area 1 case; local anesthesia 1cases in the scrotum effusion, incision hematoma 1 case,appear chronic pain in the groin area 2 case,;Compared the three groups of patients,the incidence of general anesthesia group is higher than the other two groups(P <0.05).All cases were followed up for 4~26months,the median follow-up time was 15 months. No case recurred in the three groups during that period.Conclusion: TEP and TAPP were also the safe and effective way of operation for inguinal hernia,two of them had similar affect. while the local anesthesia tension-free repair of inguinal hernia have an unparalleled advantage in old patients.The disadvantage is that more complications.the same, three of them in clinical practice are complementary. On the choice of surgical approach, physicians should be based on specific patients, to formulate appropriate individualized treatment plan, select the most optimized, and the most reasonable Surgical approach to obtain the best clinical and health economics benefits.