探讨不同手术入路对腹腔镜下腹股沟疝修补术的临床效果。

将2017年3月至2018年5月在芜湖市第五人民医院进行手术治疗的102例腹股沟疝患者，按照入院先后顺序分成对照组和观察组，每组51例。对照组采用腹腔镜经腹腹膜前疝修补术（TAPP），观察组采用腹腔镜完全腹膜外疝修补术（TEP）。比较2组患者的手术相关指标、生活质量、术后急慢性疼痛、并发症和复发情况。

观察组患者的下床活动时间、肠蠕动恢复时间、手术费用低于对照组，差异均有统计学意义（P<0.05）；但2组间的手术时间、排气时间、住院时间无统计学差异（P>0.05）；术后2天、1、3个月，2组患者之间的疼痛视觉模拟评分（VAS）评分均无统计学差异（P>0.05）；与术后2天比较，术后1、3个月2组患者的VAS评分均降低，差异有统计学意义（P<0.05）；术后3个月，2组患者的健康调查简表（SF-36）量表8个维度评分均较术前升高，差异有统计学意义（P<0.05）；但组间比较显示，2组患者的各维度评分均无统计学差异（P>0.05）；观察组患者对侧隐匿疝发现率（0）显著低于对照组（15.69%），差异有统计学意义（P<0.05）；2组间术后复发率及并发症率无统计学差异（P>0.05）。

TEP和TAPP均能有效改善腹股沟疝患者生活质量和减轻术后慢性疼痛，对术后并发症和复发的影响相同。但相比TAPP，TEP可促进患者肠蠕动恢复，缩短其下床活动时间，且能降低患者治疗负担。实际操作中，可结合医师的经验和患者个人的情况进行选择手术方式。

To compare the clinical effects of laparoscopic inguinal hernioplasty with different surgical approaches.

102 patients with inguinal hernia underwent surgical treatment in Wuhu fifth people's hospital from March 2017 to May 2018 were divided into the control group and the observation group according to the order of admission, with 51 cases in each group. The control group was given laparoscopic transabdominal preperitoneal hernia repair (TAPP), while the observation group was treated with laparoscopic total extraperitoneal hernia repair (TEP). The operation-related indicators, quality of life, acute and chronic pain, complications and recurrence were compared between the two groups.

The time to get out of bed, recovery of intestinal peristalsis and operation cost in the observation group were lower than those in the control group (P<0.05), but there were no statistical differences in the operation time, exhaust time and hospitalization time between the two groups (P>0.05). There were no significant differences in the scores of visual analogue scale (VAS) between the two groups at 2 days, 1 month and 3 months after surgery (P>0.05). However, compared with 2 days after surgery, the scores of VAS in the two groups of patients decreased at 1 month and 3 months after surgery, with significant difference (P<0.05). At 3 months after surgery, the scores of the 8 dimensions of the short from health survey-36 (SF-36) in the two groups all rose, while there were no significant differences in the scores of each dimension between the two groups (P>0.05). The discovery rate of contralateral occult hernia in the observation group was significantly lower than that in the control group (0 vs. 15.69%, P<0.05). There were no significant differences in rates of recurrence and complication between the two groups (P>0.05).

TEP and TAPP can effectively improve the quality of life and alleviate the chronic pain after operation, and have the same effect on the complications and recurrence after operation in patients with inguinal hernia. However, compared with TAPP, TEP could promote the recovery of intestinal motility, shorten the time of getting out of bed, and reduce the treatment burden of patients. In practice, appropriate surgical method can be selected according to the doctor's experience and the patient's personal situation.