Clinical effect of two surgical methods on elderly patients with recurrent inguinal hernia

Abstract

Objective To evaluate the clinical efficacy and safety of Lichtenstein operation and laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) repair combined with partial transection of preperitoneal hernia sac for the treatment of elderly patients with recurrent inguinal hernia. Methods A total of 132 patients with inguinal hernia admitted to the East campus of Second hospital of Hebei medical university between February 2013 and May 2018 were selected as subjects. They were randomly divided into the control group and the study group, with 66 cases in each group. The control group was treated with Lichtenstein operation, while the study group was treated with TAPP repair and partial peritoneal hernia sac transection. The operation time, intraoperative bleeding volume, pain degree at 4 hours after operation, first time out of bed and hospitalization time, serum IgM, IgA and IgG levels at 48 hours after operation, as well as the occurrence of complications and recurrence at 3 months follow-up were compared between the two groups. Results The operation time of the study group was significantly longer than that of the control group [(46.4±9.6) minutes vs (41.3±8.7) minutes], the amount of bleeding during operation, the pain score at 4 hours after operation and the incidence of complications in the study group after operation were significantly lower than those in the control group [(36.5±5.1) ml vs (39.2±5.4) ml, (4.6±1.5) scores vs (5.3±1.4) scores, 2 (3.03%) vs 9 (13.64%)], the first time of bed-out and hospitalization in the study group was significantly shorter than that in the control group [(14.9±3.1) hours vs (16.2±3.6) hours , (5.2±1.8) days vs (6.5±1.9) days], the levels of IgM, IgA and IgG in the study group were significantly higher than those in the control group (0.78±0.10 vs 0.67±0.11, 1.43±0.31 vs 1.26±0.25, 6.84±0.73 vs 5.79±0.61), and the differences were statistically significant (all P 0.05). Conclusion TAPP repair combined with partial transection of preperitoneal hernia sac is safe for the treatment of elderly recurrent inguinal hernia, which can recover the immune function significantly, lower the incidence of complications, and worthy popularizing in clinic. Key words: Recurrent inguinal hernia; Laparoscopes; Herniorrhaphy; Elderly patients