| ObjectiveTo study the effect of laparoscopic inguinal hernia tension-free repair and open inguinal hernia tension-free repair on quality of life,pain and scar after operation,and to provide evidence for the choice of inguinal hernia operation in clinical work.MethodsFrom July 2016 to July 2017,112 cases of inguinal hernia admitted to GI Surgery,First Affiliated Hospital of Chengdu Medical College were randomly divided into laparoscopic group(54 cases)and open group(58 cases)according to inclusion,exclusion criteria and voluntary principles.The laparoscopic group underwent laparoscopic tension-free repair of inguinal hernia(laparoscopic inguinal herniorrhaphy,LIHR)under combined anesthesia,in which 24 patients underwent total extraperitoneal hernia repair(totally extraperitoneal herniorrhaphy,TEP),30 patients were transabdominal preperitoneal herniorrhaphy(transabdominal preperitoneal herniorrhaphy,TAPP).The patch uses polypropylene and polylactic acid composite patches made by Medtronic.In the open group,tension-free repair of inguinal hernia was performed under lumbar and hard anesthesia(Lichtenstein method),using a polypropylene and polylactic acid composite patch produced by Medtronic.Record index:1.Collect the score of SF-36 quality of life questionnaire before operation,1month after operation,3 months after operation and 6 months after operation.2.IPQ pain scale scores were collected before operation,1 week after operation,1 month after operation,3 months after operation and 6 months after operation.3.Use Vancouver Scar Scale to evaluate surgical incision scar in 6 months after operation.After collecting the data,the statistical software spss 24.0 was used to analyze the data.P<0.05 was a statistically significant difference.ResultAll patients with inguinal hernia were operated smoothly,96 patients in 112 cases successfully completed all the follow-up indicators,no recurrence has occurred since the postoperative follow-up.In the study,16 cases were missed: open group lost 7 cases,laparoscopic group lost 9 cases,including TEP group lost 3 cases,TAPP group lost 6cases.The results of data collection,collation and calculation were as follows:1.In the quality of life analysis of 1 month and 3 months after operation in the laparoscopic group and the open group,the Physical Functioning(PF),Role-Physical(RP),Bodily Pain(BP),Social Functioning(SF)and Role-Emotional(RE)P<0.05,the difference has statistically significant,that is,laparoscopic treatment is superior to open in the above aspects.But the comparison in General Health(GH),Vitality(VT),and Mental Health(MH)P>0.05,that is,there is no significant difference between the two groups in the above aspects.2.In the quality of life analysis of 6 month a after operation in the laparoscopic group and the open group,the Role-Physical(RP),General Health(GH),Social Functioning(SF),and Role-Emotional(RE)P<0.05,the difference has statistically significant,that is,laparoscopic treatment is superior to open in the above aspects.But the comparison in physiological function(PF),Bodily Pain(BP),Vitality(VT),Mental Health(MH)P>0.05,that is,there is no significant difference between the two groups in the above aspects.3.In the quality of life analysis of preoperative and postoperative 6 months,the physical function(RP),physiological function(PF),Bodily Pain(BP),general health(GH),Social Functioning(SF),Role-Emotional(RE)and Mental Health(MH)P<0.05,the difference has statistically significant,that is,the quality of life after operation was better than that before operation.4.In the quality of life analysis of TEP and TAPP in 1 month,3 months and 6months after operation in the laparoscopic group,the physical pain(BP)P<0.05,the difference has statistically significant,the other P>0.05,the difference has no statistically significant,that is the Bodily Pain(BP)of TEP was lighter than TAPP in 1 month after operation.5.The pain scores of laparoscopic group and open group were statistically significant at 1 week,1month,and 3 months after operation(P<0.05).However,the score of 6 months(P>0.05)after operation was not statistically significant.That is,laparoscopy can better relieve the early postoperative pain,postoperative long-term pain between the two groups no significant difference.6.The pain scores of 1 week,1 month,3 months and 6 months after TAPP and TEP in the laparoscopic group were P>0.05,the difference has no statistically significant.That is,there was no significant difference in postoperative pain between TAP and TEP.7.The scores of scars in laparoscopic group and open group at6 months after operation were P<0.05,the difference has statistically significant.That is,The width of incision scar after laparoscopic operation is narrower and more beautiful.ConclusionLaparoscopic and open surgery for inguinal hernia can improve the quality of life of patients significantly.Compared with open hernia repair,patients undergoing laparoscopic surgery have faster recovery of physical health and Mental Health,earlier recovery of daily activities,faster recovery of self-care ability,better and earlier daily work and social activities,and better postoperative quality of life in the early postoperative period.In terms of postoperative physical pain,laparoscopic herniorrhaphy has the advantages of light pain and quick relief,while TEP has more obvious advantages in reducing postoperative physical pain in the near future.The scar is smaller and more beautiful after laparoscopic surgery. |
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