探讨改良腹腔镜完全腹膜外疝修补术（TEP）和腹腔镜经腹腹膜前疝修补术（TAPP）治疗腹股沟疝的有效性和安全性。

回顾性分析2017年1月至2019年1月，肇庆市第一人民医院行改良腹腔镜TEP术治疗的55例腹股沟疝患者作为改良TEP组，同时收集同期行TAPP术治疗的55例腹股沟疝患者作为TAPP组。观察并比较2组的手术指标、住院指标、术中情况以及并发症发生情况。

改良TEP组患者的手术时间、恢复正常活动时间、住院时间均短于TAPP组，术中出血量、术后VAS评分、住院费用均低于TAPP组，差异均有统计学意义（P<0.05）。2组患者术中情况比较，其大出血、分破腹膜、分破疝囊、肠道损伤、损伤神经、损伤血管、游离腹壁下血管发生率比较，差异无统计学意义（P>0.05）。改良TEP组近期及远期并发症发生率与TAPP组比较，差异均无统计学意义（P>0.05）。

TAPP，改良TEP治疗腹股沟疝，安全性良好，相较于TAPP，改良TEP可缩短手术时间，降低出血量，同时减轻术后疼痛，促进腹股沟疝患者术后恢复，降低住院费用，但其对术者要求较高，临床应根据实际情况进行选择。

To investigate the efficacy and safety of laparoscopic modified total extraperitoneal hernia repair (TEP) and laparoscopic transabdominal preperitoneal hernia repair (TAPP) in the treatment of inguinal hernia.

55 patients with inguinal hernia treated by modified laparoscopic TEP in our hospital from January 2017 to January 2019 were retrospectively selected as the modified TEP group, and 55 patients with inguinal hernia treated by TAPP at the same time were collected as the TAPP group. The operative indexes, hospitalization indexes, intraoperative conditions and complications were observed and compared between the two groups.

The operation time, recovery time and hospitalization time of patients in the modified TEP group were shorter than those in the TAPP group, and the intraoperative blood loss, postoperative VAS score and hospitalization expenses were lower than those in the TAPP group (P<0.05). There was no significant difference in the incidence of massive hemorrhage, peritoneum, hernial sac, intestinal tract injury, nerve injury, blood vessel injury and free inferior epigastric vessel between the two groups (P>0.05). There was no statistical difference in the incidence of short-term and long-term complications between the two groups (P>0.05).

TAPP and modified TEP have good safety in the treatment of inguinal hernia. Compared with TAPP, modified TEP can shorten the operation time, reduce the amount of bleeding, reduce postoperative pain, promote postoperative recovery of inguinal hernia patients, and reduce hospitalization expenses. However, it has higher requirements on the operator and should be selected according to the actual situation in clinic.