Comparison on the effect of hernia sac transection and total dissection in laparoscopic preperitoneal herniorrhaphy

Abstract

Objective To compare the effect on hernia sac transection and total dissection in transperitoneal inguinal hernia repair (TAPP). Methods 120 patients underwent TAPP from July 2016 to June 2018 in Rugao Hospital of Traditional Chinese Medicine were selected. The observation group was treated with hernia sac transection and the control group was treated with hernia sac total dissection, with 60 cases in each group. The surgical/hospitalization related indicators, quality of life and postoperative complications were observed and compared between the two groups. Results The operation time, intraoperative bleeding volume, hernia sac manage time, inguinal effusion of 5 days after operation, hospitalization expenses and visual analogue score (VAS) at the 2rd day after operation in the observation group [(47.11±4.15) minutes, (3.24±1.01) ml, (9.57±2.74) minutes, (5.27±1.09) ml, (8 105.69±251.67) yuan, (2.11±0.97) scores] were lower than those in the control group [(57.69±5.28) minutes, (6.71±2.14) ml, (25.13±4.29) minutes, (13.75±3.56) ml, (11 241.55±397.52) yuan, (4.59±1.13) scores], with statistical differences (t=12.203、11.359、23.678、17.643、51.628、12.899, all P 0.05). In six months after the operation, the scores of Short Form Health Survey-36 (SF-36) and the Barthel Index (BI) in the observation group [(82.19±8.95) sores, (83.01±7.94) sores] were higher than those in the control group [(75.11±8.02) sores, (76.25±7.19) sores], while the score of improved Rankin scale (mRS) (73.19±7.02) sores was lower than that in the control group (84.17±7.85) sores, with statistical differences (t=4.563、4.888、8.076, all P<0.001). The incidence of neurosensory abnormalities and total complications in the observation group were 0 and 1.67% respectively, which were significantly lower than those in the control group (8.33% and 18.33%, χ2=5.217、9.259, P=0.022、0.002). Conclusion In TAPP repair, compared with hernia sac dissection, therapy of hernia sac transection can reduce operation time and operation injury, relieve postoperative pain, and the incidence of complications is lower, which is helpful for recovery and improve their quality of life. Key words: Transperitoneal inguinal hernia repair; Hernia sac dissection; Hernia sac transection; pain; Quality of life; Complications