探讨及腹腔镜下完全腹膜外疝修补术（TEP）、腹腔镜经腹腹膜疝前修补术（TAPP）及开放式无张力修补术（OTFH）的临床疗效。

分层抽取2014年1月至2018年4月深圳市南山区人民医院腹股沟疝患者578例，根据手术方式分为3组。比较3组患者手术情况、术后疼痛、并发症、住院费用及复发情况。

TEP组与TEPP组在手术时间、术中出血、术后疼痛评分、并发症和复发率均显著低于OTFH组（P<0.05），但费用显著高于OTFH组（P<0.05）。TEP组在手术时间、术中出血显著优于TAPP组（P<0.05）；TEP组和TAPP组之间手术费用、并发症和复发率比较，差异无统计学意义（P>0.05）。

三种手术均是治疗腹股沟疝的安全、有效的手术方式，TEP在手术时间、术中出血中有明显优势，腹股沟疝患者就医体验最优。但操作要求更高，需要手术器械进步更进一步缩短学习曲线。

To investigate the clinical efficacy of laparoscopic totally extra-peritoneal hernia repair (TEP), laparoscopic trans-abdominal preperitoneal hernia repair (TAPP) and open tension-free repair (OTFH).

578 inguinal hernia patients who underwent surgery in Shenzhen Nanshan District People's Hospital, were enrolled from January 2014 to April 2018. They were divided into TEP group, TAPP group and OTFH group according to the surgical method. The surgical conditions, postoperative pain, complications, hospitalization costs and recurrence of patients in the three groups were compared.

The operation time, intraoperative bleeding, postoperative pain score, complications and recurrence rate of TEP group and TAPP group were significantly lower than those of OTFH group (P<0.05), but the cost was significantly higher than that of OTFH group (P<0.05). The TEP group was significantly superior to the TAPP group in terms of operation time and intraoperative bleeding (P<0.05), and there were no statistical differences in operation cost, complications and recurrence rate between the TEP group and TAPP group (P>0.05).

TEP, TAPP and OTFH are safe and effective operation methods in hernia surgery, TEP has obvious advantages in operation time and intraoperative bleeding, and it has the best medical experience for patients with inguinal hernia. However, the operation requirement is higher. Surgical advances are needed to further shorten the learning curve.