Comparison of efficacy of laparoscopic herniorrhaphy with or without mesh fixation and open tension-free herniorrhaphy

Abstract

Objective To compare the effectiveness and safety of laparoscopic herniorrhaphy with or without mesh fixation and open tension-free herniorrhaphy in treatment of inguinal hernia, and to provide a basis for the choice of future inguinal hernia repair. Methods The clinical data of 93 cases of inguinal hernia in the Baoying County people's hospital from January 2015 to January 2018 were retrospectively analyzed. All the patients were divided into three groups by surgical procedures, group A: laparoscopic herniorrhaphy with mesh fixation (n=34), group B: laparoscopic herniorrhaphy without mesh fixation (n=31), group C: open tension-free herniorrhaphy (n=28). After 1-year postoperative follow-up, the surgical conditions, postoperative complications and recurrence rate were compared among the three groups. Results There were no statistical differences in the intraoperative bleeding volume, operation time, postoperative leaving bed time, feeding time, duration of pain, hospital stays and postoperative 2 d pain score between group B and group A (P>0.05); The intraoperative bleeding volume in group A and group B was less than that in group C; the postoperative leaving bed time, feeding time, duration of pain and hospital stays in group A and group B were shorter than those in group C; the postoperative 2 d pain score in group A and group B was lower than that in group C (P 0.05); There was no statistical difference in the incidence of postoperative complications and recurrence rate among group A, B and C (P>0.05). Conclusion The efficacy of laparoscopic herniorrhaphy and open tension-free herniorrhaphy in the treatment of inguinal hernia are similar. All of them have satisfactory safety with less complications. However, because laparoscopic surgery does not require a large incision, the patients suffer less trauma and achieve rapid postoperative recovery, whose application value is superior to open surgery. The laparoscopic herniorrhaphy without mesh fixation can still obtain similar effects compared with laparoscopic herniorrhaphy with mesh fixation, so that laparoscopic herniorrhaphy without mesh fixation is simple in operation and less in complications, which has higher clinical promotional value. Key words: Laparoscopic herniorrhaphy; Mesh fixation; Open tension-free herniorrhaphy