Abstract

Objective To compare the clinical efficacy and safety of laparoscopic transabdominal preperitoneal hernia repair (TAPP), totally extraperitoneal hernia repair (TEP), open tension-free herniorrhaphy (Lichtenstein surgery) in treatment of inguinal hernia. Methods 150 cases of patients with inguinal hernia admitted to the Songzi People's hospital from March 2015 to August 2017 were selected as the research object. All the patients were divided into Lichtenstein group, TAPP group and TEP group according to random number table method, with 50 cases in each group. The surgical indexes, complications, postoperative 6-month recurrence rate were compared among the three groups. The changes of stress response [cortisol (Cor), norepinephrine (NE), aldosterone (ALD)] of perioperative patients were observed. Results There was no statistical difference in the operation time and the incidence of postoperative complications among the three groups (P>0.05); The intraoperative bleeding volume, postoperative 12 h NRS score, postoperative leaving bed time, hospital stays in Lichtenstein group were higher than those in TAPP group and TEP group, while the hospitalization expense of Lichtenstein group was lower than that of TAPP group and TEP group, and the difference was statistically significant (P<0.05); The postoperative 3 d Cor, NE, ALD levels, recurrence rate in Lichtenstein group were higher than those in TAPP group and TEP group, and the difference was statistically significant (P<0.05). Conclusion Lichtenstein surgery in treatment of inguinal hernia is easy operation and has low expense, while laparoscopic TAPP and TEP have characteristics of small trauma, slight pain, less complications and low recurrence rate. Therefore, it is necessary to select suitable surgical procedure according to patients' specific conditions. Key words: Inguinal hernia; TAPP surgery; TEP surgery; Lichtenstein surgery; Efficacy; Complications

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