比较经腹腹膜前（TAPP）与完全腹膜外（TEP）腹腔镜腹股沟疝修补术对成人腹股沟斜疝的治疗效果。

采用回顾性队列研究方法，选取2021年1月至2022年1月于安徽省马鞍山市人民医院行TAPP、TEP治疗的154例患者数据进行倾向性匹配评分，纳入2组间基线差异无统计学意义的患者，根据纳入排除标准最终纳入61例腹股沟斜疝患者的临床资料，根据手术方法的不同将其分为TAPP组（31例）及TEP组（30例）。统计2组手术相关指标及术后疼痛程度、胃肠功能恢复情况、血清肿发生情况、并发症发生率、术后1年疝复发率。

2组患者手术成功率均为100%。TEP组手术时间短于TAPP组，术中出血量少于TAPP组（t=3.942、4.964，P均<0.001）。TEP组术后1、2 d的视觉模拟评分低于TAPP组（t=2.677、P=0.010，t=2.294、P=0.025）。TEP组肠鸣音恢复时间、首次肛门排气时间、首次进食时间及初次排便时间短于TAPP组（t=2.316、P=0.024，t=2.684、P<0.01，t=5.281、P<0.001，t=3.654、P=0.001）。2组患者血清肿发生情况及并发症发生率比较差异无统计学意义（Z=0.612、P=0.434，χ²=0.223、P=0.367）。TAPP组、TEP组术后1年疝复发率分别为6.45%（2/31）、3.33%（1/30），差异无统计学意义（χ²=0.317，P>0.05）。

TEP治疗成人腹股沟斜疝较TAPP手术时间更短、术中出血更少、创伤更小，且可改善胃肠功能，但两种术式对术后复发的影响不大。

To compare the therapeutic effect of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) laparoscopic inguinal hernia repair in the treatment of indirect inguinal hernia in adults.

Adopting retrospective cohort study, data of 154 patients who received TAPP and TEP treatment in Maanshan People's Hospital, Anhui Province from January 2021 to January 2022 were selected for propensity matching score. Patients with no statistically significant baseline differences in both groups were included, and clinical data of 61 patients with indirect inguinal hernia were finally enrolled according to the inclusion and exclusion criteria.According to different surgical methods, the patients were divided into TAPP group (31 cases) and TEP group (30 cases). The surgery-related indicators, postoperative pain degree, gastrointestinal function recovery status, seroma occurrence, incidence rates of complications and recurrence rate at 1 year after surgery were analyzed in the two groups.

The success rate of surgery was 100% in both groups. The surgical time in TEP group was shorter than that in TAPP group, and the intraoperative blood loss was less than that in TAPP group (t=3.942, 4.964, all P<0.001). The visual analogue scale scores in TEP group at 1 and 2 d after surgery were lower than those in TAPP group (t=2.677, P=0.010; t=2.294, P=0.025). The bowel sound recovery time, the first anal exhaust time, first feeding time, and first defecation time were shorter in TEP group than those in TAPP group (t=2.316, P=0.024; t=2.684, P<0.01; t=5.281, P<0.001; t=3.654, P=0.001). There were no statistical differences in occurrence of seroma and incidence rates of complications between the two groups (Z=0.612, P=0.434; χ²=0.223, P=0.367). The recurrence rates in TAPP group and TEP group at 1 year after surgery were 6.45% (2/31) and 3.33% (1/30) respectively, with no significant statistical differences (χ²=0.317, P>0.05).

Compared with TAPP, TEP has shorter surgical time, less intraoperative blood loss and less trauma in the treatment of adult indirect inguinal hernia, and it can improve the gastrointestinal function, but the two surgical methods have little effect on postoperative recurrence.